Targeting poly-gama-glutamic acid to treat Staphylococcus epidermidis and related infections

ABSTRACT

Immunogenic compositions and methods for eliciting an immune response against  S. epidermidis  and other related staphylococci are provided. The immunogenic compositions can include immunogenic conjugates of poly-γ-glutamic acid (such as γDLPGA) polypeptides of  S. epidermidis , or related staphylococci that express a γPGA polypeptide. The γPGA conjugates elicit an effective immune response against  S. epidermidis , or other staphylococci, in subjects to which the conjugates are administered. A method of treating an infection caused by a  Staphylococcus  organism that expresses cap genes is also disclosed. The method can include selecting a subject who is at risk of or has been diagonosed with the infection by the  Staphylococcus  organism which expresses γPGA from the cap genes. Further, the expression of a γPGA polypeptide by the organism can then be altered.

CROSS REFERENCE TO RELATED APPLICATIONS

This is a divisional application of U.S. application Ser. No.13/035,716, filed Feb. 25, 2011 , now U.S. Pat. No. 8,252,550, which isa divisional of U.S. application Ser. No. 11/994,984, filed Jan. 7, 2008(now abandoned), which is the §371 U.S. National Stage of InternationalApplication No. PCT/US2006/026900, filed Jul. 10, 2006, which waspublished in English under PCT Article 21(2), which in turn claims thebenefit of U.S. Provisional Patent Application No. 60/697,646, filedJul. 8, 2005. The entire disclosures of the prior applications areconsidered to be part of the disclosure of the accompanying applicationand are hereby incorporated by reference.

FIELD OF THE DISCLOSURE

This invention relates to the field of infectious disease, and thetreatment of certain infections, such as Staphylococcus epidermidisinfections, and to immunogenic compositions and methods for eliciting animmune response against Staphylococcus epidermidis.

BACKGROUND

Coagulase-negative staphylococci, with the leading speciesStaphylococcus epidermidis (S. epidermidis), have over the past decadebecome the most prevalent pathogens involved in hospital-acquiredinfections (Vuong, C., and Otto, M. Microbes Infect. 4: 481-489, 2002).For example, in the United States alone, S. epidermidis infections onin-dwelling medical devices cost the public health system approximatelyone billion dollars per year (Vuong, C., and Otto, M. Microbes Infect.4: 481-489, 2002).

S. epidermidis is usually an innocuous commensal microorganism on humanskin. This microorganism can cause severe infection after penetration ofthe epidermal protective barriers of the human body. To survive on thehuman skin and during infection of in-dwelling medical devices, S.epidermidis circumvents human innate host defenses (Hornef, M. W., Wick,M. J., Rhen, M., and Normark, S, Nat. Immunol. 3: 1033-1040, 2002). Forexample, S. epidermidis is frequently resistant to common antibiotics(Vuong, C., and Otto, M. Microbes Infect. 4:481-489, 2002). Theformation of surface-attached cellular agglomerations known as biofilmsis believed to contribute significantly to antibiotic resistance andprotection of the organism from innate host defense (Costerton, J. W.,Steward, P. S., and Greenberg, E. P. Science. 284: 1318-1322, 1999).Further, it has been suggested that resistance of S. epidermidisbiofilms to some antibiotics is in part due to a status of generallyreduced metabolism (Yao, Y., Sturdevant, D. E., and Otto, M. J. Infect.Dis. 191: 289-298, 2005). Thus, S. epidermidis is one of the difficulthard-to-treat infectious agents that can be transmitted nosocomially topatients in hospitals, especially such patients who have in-dwellingmedical implants.

It would be advantageous to provide compositions and methods of treatingstaphylococcal infectiouns, such as coagulase-negative staphylococcalinfections, for example S. epidermidis infections.

SUMMARY

Certain staphylococci secrete poly-γ-glutamic acid (γPGA) that has nowbeen found to facilitate growth and survival of these bacterialpathogens in hosts. γPGA efficiently shelters these pathogens frominnate host immune defenses, such as antimicrobial peptides andneutrophil phagocytosis, and is important for microbial persistenceduring an infection, such as a device-related infection. The γPGA alsoprotects the organism against other antimicrobial defenses, such as thehigh salt concentration that is found on the skin. The γPGA thereforepresents an important new biological target for therapies aimed attreating diseases caused by staphylococci that secrete γPGA, such ascoagulase-negative staphylococci, including S. epidermidis. In certainembodiments, the γPGA target is poly-γ-D-L-glutamic acid (γDLPGA), whichis preferentially expressed by S. epidermidis.

An immunogenic conjugate is disclosed. In an aspect, the immunogenicconjugate includes a Staphylococcus capsular γPGA polypeptide and anadjuvant. For example, the conjugate may be linked to a carrier protein.The conjugate elicits an immune response in a subject. In one example,the conjugate is administered to treat, reduce, ameliorate or prevent acoagulase-negative staphylococcus-induced infection such as an S.epidermidis infection on an in-dwelling medical device.

A method is also disclosed for treating (including preventing) aninfection caused by a Staphylococcus organism that secretes γPGApolypeptides, for example an organism that expresses cap genes. Themethod can include selecting a subject who is at risk of or has beendiagnosed with the infection by the Staphylococcus organism whichexpresses γPGA and interfering with the microbial protective effectprovided by the γPGA. In some examples, this interference takes the formof stimulating an immune response against the γPGA, administeringantisera against it, or disrupting expression of the γPGA by theorganism.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1A is a schematic representation of phylogenetic trees based onsequence comparisons of capB (amide ligase), capC (unknown function) andcapD (depolymerase) genes.

FIG. 1B is a gene locus map of various cap genes and homologs inbacteria.

FIG. 2A shows a representative immuno-dot blot and a graph of therelative γPGA expression in wildtype, complemented strain S. epidermidisΔcap (capBCAD) and isogenic cap mutant strain (Δcap).

FIG. 2B shows scanning electron micrographs illustrating the detectionof γPGA in wildtype, capBCAD and Δcap by anti-PGA antiserum.

FIG. 2C is a graph displaying the amounts of D-glutamic (D-Glu) andL-glutamic (L-Glu) acid detected by stereoselective chromatography andliquid chromatographic-mass spectrometric in wildtype, capBCAD and Δcap.

FIG. 3 is a graph demonstrating γPGA expression in S. epidermidisstrains of clinical and commensal origin under low and high salt (2 MNaCl) conditions.

FIG. 4A is a graph depicting the growth (OD₆₀₀) of wild-type and capmutant strains in Luria-Bertani medium supplemented with 2 M NaCl.

FIG. 4B is a graph displaying the viability (CFU) of wild-type and capmutant strains in Luria-Bertani medium supplemented with 2 M NaCl.

FIG. 4C is a graph representing NaCl inducibility of cap expressionmeasured by quantitative real-time PCR analysis.

FIGS. 5A and 5B are graphs illustrating the resistance to cationicantimicrobial peptides in wildtype, capBCAD and Δcap followingincubation with LL-37 (FIG. 5A) or human β-defensin 3 (FIG. 5B).

FIG. 5C is a graph depicting the resistance to human neutrophilphagocytosis in wildtype, capBCAD and Δcap following incubation with S.epidermidis.

FIG. 5D is a graph demonstrating the viability (CFU) of S. epidermidiscells on subcutaneous devices implanted in mice infected with wild typestrain of S. epidermidis or Δcap mutant strain.

SEQUENCE LISTING

The nucleic acid sequences listed in the accompanying sequence listingare shown using standard letter abbreviations for nucleotide bases asdefined in 37 C.F.R. 1.822. Only one strand of each nucleic acidsequence is shown, but the complementary strand is understood asincluded by any reference to the displayed strand. In the accompanyingsequence listing:

SEQ ID NOs: 1-3 are representative oligonucleotide primer sequencesutilized for real-time PCR analysis of cap expression.

SEQ ID NOs: 4-7 are representative oligonucleotide primer sequencesemployed for allelic replacement of the cap locus.

SEQ ID NOs: 8 and 9 are representative oligonucleotide primer sequencesutilized for construction of complementation vectors.

SEQ ID NOs: 10-13 are representative oligonucleotide primer sequencesused to confirm lack of cap expression in the cap mutant strain byreal-time PCR.

SEQ ID NOs: 14-21 are illustrations of oligonucleotide primer sequencesemployed for amplification of the capB probe by Southern blot.

DETAILED DESCRIPTION OF SEVERAL EMBODIMENTS

I. Abbreviations

ADH: adipic acid dihydrazide EF: edema factor PGA: poly-γ-glutamic acidγPGA: poly-γ-glutamic acid capsule γDPGA: poly-γ-D-glutamic acid capsuleγLPGA: poly-γ-L-glutamic acid capsule γDLPGA: poly-γ-D-L-glutamic acidcapsule GLC-MS: gas-liquid chromatography-mass spectrometry LC-MS:liquid chromatography-mass spectrometry MALDI-TOF: matrix-assisted laserdesorption ionization time-of-flight μg: microgram μl: microliter M:molar NaCl sodium chloride PA: protective antigen PBS: phosphatebuffered saline PCR: polymerase chain reaction PIA: polysaccharideintercellular adhesin TSB: tryptic soy brothII. Terms

Unless otherwise noted, technical terms are used according toconventional usage. Definitions of common terms in molecular biology maybe found in Benjamin Lewin, Genes VII, published by Oxford UniversityPress, 2000 (ISBN 019879276X); Kendrew et al. (eds.), The Encyclopediaof Molecular Biology, published by Blackwell Publishers, 1994 (ISBN0632021829); and Robert A. Meyers (ed.), Molecular Biology andBiotechnology: a Comprehensive Desk Reference, published by Wiley, John& Sons, Inc., 1995 (ISBN 0471186341); and other similar references.

As used herein, the singular terms “a,” “an,” and “the” include pluralreferents unless context clearly indicates otherwise. Similarly, theword “or” is intended to include “and” unless the context clearlyindicates otherwise. Also, as used herein, the term “comprises” means“includes.” Hence “comprising A or B” means including A, B, or A and B.It is further to be understood that all nucleotide sizes or amino acidsizes, and all molecular weight or molecular mass values, given fornucleic acids or polypeptides are approximate, and are provided fordescription. Although methods and materials similar or equivalent tothose described herein can be used in the practice or testing of thepresent disclosure, suitable methods and materials are described below.All publications, patent applications, patents, and other referencesmentioned herein are incorporated by reference in their entirety.Further, all Genbank references are incorporated by reference in theirentirety as of their listings on Jul. 10, 2006. In case of conflict, thepresent specification, including explanations of terms, will control. Inaddition, the materials, methods, and examples are illustrative only andnot intended to be limiting.

In order to facilitate review of the various embodiments of thisdisclosure, the following explanations of specific terms are provided:

Adjuvant: A substance that non-specifically enhances the immune responseto an antigen. Development of vaccine adjuvants for use in humans isreviewed in Singh et al. (Nat. Biotechnol. 17:1075-1081, 1999), whichdiscloses that, at the time of its publication, aluminum salts, such asaluminum hydroxide (Amphogel, Wyeth Laboratories, Madison, N.J.), andthe MF59 microemulsion are vaccine adjuvants approved for human use.

In one embodiment, an adjuvant includes a DNA molecule with a motif thatstimulates immune activation, for example the innate immune response orthe adaptive immune response by T-cells, B-cells, monocytes, dendriticcells, and natural killer cells. Specific, non-limiting examples of aDNA motif that stimulates immune activation include CpGoligodeoxynucleotides, as described in U.S. Pat. Nos. 6,194,388;6,207,646; 6,214,806; 6,218,371; 6,239,116; 6,339,068; 6,406,705; and6,429,199. Another embodiment of an adjuvant is the carrier describedherein.

Analog, Derivative or Mimetic: An analog is a molecule that differs inchemical structure from a parent compound, for example a homolog(differing by an increment in the chemical structure, such as adifference in the length of an alkyl chain), a molecular fragment, astructure that differs by one or more functional groups, a change inionization. Structural analogs are often found using quantitativestructure activity relationships (QSAR), with techniques such as thosedisclosed in Remington (The Science and Practice of Pharmacology, 19thEdition (1995), chapter 28). A derivative is a biologically activemolecule derived from the base structure. A mimetic is a molecule thatmimics the activity of another molecule, such as a biologically activemolecule. Biologically active molecules can include chemical structuresthat mimic the biological activities of a compound.

Animal: Living multi-cellular vertebrate organisms, a category thatincludes, for example, mammals and birds. The term mammal includes bothhuman and non-human mammals. Similarly, the term “subject” includes bothhuman and veterinary subjects, for example, humans, non-human primates,dogs, cats, horses, and cows.

Antibody: A protein (or protein complex) that includes one or morepolypeptides substantially encoded by immunoglobulin genes or fragmentsof immunoglobulin genes. The recognized immunoglobulin genes include thekappa, lambda, alpha, gamma, delta, epsilon, and mu constant regiongenes, as well as the myriad of immunoglobulin variable region genes.Light chains are classified as either kappa or lambda. Heavy chains areclassified as gamma, mu, alpha, delta, or epsilon, which in turn definethe immunoglobulin classes, IgG, IgM, IgA, IgD and IgE, respectively.

The basic immunoglobulin (antibody) structural unit is generally atetramer. Each tetramer is composed of two identical pairs ofpolypeptide chains, each pair having one “light” (about 25 kDa) and one“heavy” (about 50-70 kDa) chain. The N-terminus of each chain defines avariable region of about 100 to 110 or more amino acids primarilyresponsible for antigen recognition. The terms “variable light chain”(V_(L)) and “variable heavy chain” (V_(H)) refer, respectively, to theselight and heavy chains.

As used herein, the term “antibodies” includes intact immunoglobulins aswell as a number of well-characterized fragments. For instance, Fabs,Fvs, and single-chain Fvs (SCFvs) that bind to target protein (orepitope within a protein or fusion protein) would also be specificbinding agents for that protein (or epitope). These antibody fragmentsare defined as follows: (1) Fab, the fragment which contains amonovalent antigen-binding fragment of an antibody molecule produced bydigestion of whole antibody with the enzyme papain to yield an intactlight chain and a portion of one heavy chain; (2) Fab′, the fragment ofan antibody molecule obtained by treating whole antibody with pepsin,followed by reduction, to yield an intact light chain and a portion ofthe heavy chain; two Fab′ fragments are obtained per antibody molecule;(3) (Fab′)₂, the fragment of the antibody obtained by treating wholeantibody with the enzyme pepsin without subsequent reduction; (4)F(ab′)₂, a dimer of two Fab′ fragments held together by two disulfidebonds; (5) Fv, a genetically engineered fragment containing the variableregion of the light chain and the variable region of the heavy chainexpressed as two chains; and (6) single chain antibody, a geneticallyengineered molecule containing the variable region of the light chain,the variable region of the heavy chain, linked by a suitable polypeptidelinker as a genetically fused single chain molecule. Methods of makingthese fragments are routine (see, for example, Harlow and Lane, UsingAntibodies: A Laboratory Manual, CSHL, New York, 1999).

Antibodies for use in the methods and devices of this disclosure can bemonoclonal or polyclonal. Merely by way of example, monoclonalantibodies can be prepared from murine hybridomas according to theclassical method of Kohler and Milstein (Nature 256:495-97, 1975) orderivative methods thereof. Detailed procedures for monoclonal antibodyproduction are described in Harlow and Lane, Using Antibodies: ALaboratory Manual, CSHL, New York, 1999.

Antigen: A compound, composition, or substance that may be specificallybound by the products of specific humoral or cellular immunity, such asan antibody molecule or T-cell receptor. In one embodiment, an antigenis a Staphylococcus antigen, such as γPGA.

Bacillus: A genus of bacteria whose collective features includedegradation of most substrates derived from plant and animal sources,including cellulose, starch, pectin, proteins, agar, hydrocarbons, andothers; antibiotic production; nitrification; denitrification; nitrogenfixation; facultative lithotrophy; autotrophy; acidophily; alkaliphily;psychrophily, thermophily and parasitism. Spore formation, universallyfound in the genus, is thought to be a strategy for survival in the soilenvironment, wherein the bacteria predominate. Aerial distribution ofdormant spores likely explains the occurrence of Bacillus species inmost habitats examined.

There are more than 40 recognized species in the genus Bacillus(Bergey's Manual of Systematic Bacteriology Vol. 2 (1986)). Theseinclude, but are not limited to, B. acidocaldarius, B. alkalophilus, B.alvei, B. anthracis, B. azotoformans, B. badius, B. brevis, B. cereus,B. circulans, B. coagulans, B. fastidiosis, B. firmus, B. globisporus,B. insolitus, B. larvae, B. laterosporus, B. lentimorbus, B. lentus, B.licheniformis, B. macerans, B. macquariensis, B. marinus, B. megaterium,B. mycoides, B. pantothenticus, B. pasteurii, B. polymyxa, B. popillia,B. pumilus, B. schlegelii, B. sphaericus, B. stearothermophilus, B.subtilis, and B. thuringiensis. In one specific, non-limiting example, aBacillus is Bacillus anthracis, the agent that causes anthrax.

Bacillus Anthracis: The etiologic agent of anthrax, Bacillus anthracisis a large, gram-positive, nonmotile, spore-forming bacterial rod. Thevirulence of B. anthracis is dependent on anthrax toxin and the γDPGAcapsule. The genes for the toxin, and the capsule, are carried byplasmids, designated pX01 and pX02, respectively (Mikesell et al.,Infect. Immun. 39:371-76, 1983; Vodkin et al., Cell 34:693-97, 1983;Green et al., Infect. Immun. 49:291-97, 1985).

The γDPGA capsule of B. anthracis serves as an essential virulencefactor during anthrax infection, inhibiting host defense mechanismsthrough inhibition of phagocytosis of the vegetative bacterial cells bymacrophages. While other Bacillus produce γPGA in a mixture of both D-and L-forms, only B. anthracis is known to synthesize it exclusively ina D-conformation (Kovács et al., J. Chem. Soc. 4255-59, 1952). Wheninjected into a subject, γDPGA has been shown to be a poor immunogen(Eisner, Schweiz. Z. Pathal. Bakteriol. 22:129-44, 1959; Ostroff et al.,Proc. Soc. Exp. Biol. Med. 99:345-47, 1958). The capsule also shieldsthe vegetative form of B. anthracis from agglutination by monoclonalantibodies that bind to or recognize its cell wall polysaccharide(Ezzell et al., J. Clin. Microbiol. 28:223-31, 1990).

Carrier: An immunogenic macromolecule to which an antigenic but nothighly immunogenic molecule, such as, for example, a homopolymer ofγPGA, can be bound. When bound to a carrier, the bound molecule becomesmore immunogenic. Carriers are chosen to increase the immunogenicity ofthe bound molecule and/or to elicit antibodies against the carrier thatare diagnostically, analytically, and/or therapeutically beneficial.Covalent linking of a molecule to a carrier confers enhancedimmunogenicity and T-cell dependence (Pozsgay et al., PNAS 96:5194-97,1999; Lee et al., J. Immunol. 116:1711-18, 1976; Dintzis et al., PNAS73:3671-75, 1976). Useful carriers include polymeric carriers, which canbe natural (for example, polysaccharides, polypeptides or proteins frombacteria or viruses), semi-synthetic or synthetic materials containingone or more functional groups to which a reactant moiety can beattached.

Examples of bacterial products useful as carriers include bacterialtoxins, such as B. anthracis protective antigen (including fragmentsthat contain at least one antigenic epitope, and analogs or derivativescapable of eliciting an immune response), lethal factor and lethaltoxin, and other bacterial toxins and toxoids, such as tetanustoxin/toxoid, diphtheria toxin/toxoid, P. aeruginosa exotoxin/toxoid,pertussis toxin/toxoid, and C. perfringens exotoxin/toxoid. Additionalbacterial products for use as carriers include bacterial wall proteinsand other products (for example, streptococcal or staphylococcal cellwalls and LPS). Viral proteins, such as hepatitis B surface antigen andcore antigen, can also be used as carriers, as well as proteins fromhigher organisms such as keyhole limpet hemocyanin, horseshoe crabhemocyanin, edestin, mammalian serum albumins, and mammalianimmunoglobulins.

Covalent Bond: An interatomic bond between two atoms, characterized bythe sharing of one or more pairs of electrons by the atoms. The terms“covalently bound” and “covalently linked” refer to making two separatemolecules into one contiguous molecule. The terms in particular examplesinclude reference to joining a γPGA polypeptide directly to a carriermolecule, and to joining a γPGA polypeptide indirectly to a carriermolecule, with an intervening linker molecule.

Epitope: An antigenic determinant. These are particular chemical groupsor contiguous or non-contiguous peptide sequences on a molecule that areantigenic, that is, that elicit a specific immune response. An antibodybinds a particular antigenic epitope based on the three dimensionalstructure of the antibody and the matching (or cognate) epitope.

Homopolymer: A polymer formed by the bonding together of multiple unitsof a single type of molecular species, such as a single monomer (forexample, an amino acid).

Immune Response: A response of the immune system, such as by a B-cell,T-cell, macrophage or polymorphonucleocyte, to a stimulus such as anantigen. An immune response can include any cell of the body involved ina host defense response for example, an epithelial cell that secretes aninterferon or a cytokine. An immune response includes, but is notlimited to, an innate immune response or inflammation.

Immunogenic Conjugate or Composition: Terms used herein to mean acomposition useful for stimulating or eliciting a specific immuneresponse (or immunogenic response) in a vertebrate. In some embodiments,the immunogenic response is protective or provides protective immunity,in that it enables the vertebrate animal to better resist infection ordisease progression that results from infection with the organismagainst which the immunogenic composition is directed.

In an embodiment, the immunogenic conjugate can be directed to amolecule instead of just an organism. For example, it is believed thatan immunogenic response can arise from the generation of an antibodyspecific to one or more of the epitopes provided in the immunogeniccomposition. The response can include a T-helper or cytotoxic cell-basedresponse to one or more of the epitopes provided in the immunogeniccomposition. All of these responses may originate from naïve or memorycells. A response can also include production of cytokines. One specificexample of a type of immunogenic composition is a vaccine. Animmunogenic composition is also referred to as a immune-stimulatingcomposition.

Immunogen: A compound, composition, or substance which is capable, underappropriate conditions, of stimulating an immune response, such as theproduction of antibodies or a T-cell response in an animal, includingcompositions that are injected or absorbed into an animal.

Immunologically Effective Dose: An immunologically effective dose is atherapeutically effective dose. For example, the γPGA conjugates of thedisclosure are therapeutically effective and will prevent, treat,lessen, or attenuate the severity, extent or duration of a disease orcondition such as an infection by S. epidermidis.

In-dwelling medical device: A device or medical implant which is toreside within a subject for an extended period of time (ranging fromminutes to years). Examples of in-dwelling medical devices include, butare not limited to, catheters, artificial joints, pacemakers, and heartvalves.

Inhibiting or Treating a Disease: Inhibiting the progressive or fulldevelopment of a disease or condition in a subject who is at risk forinfection with a pathogen such as S. epidermidis. “Treatment” refers toa therapeutic intervention that ameliorates a sign or symptom of adisease or pathological condition either before or after it has begun todevelop. As used herein, the term “ameliorating,” with reference to adisease, pathological condition or symptom, refers to any observablebeneficial effect of the treatment. The beneficial effect can beevidenced, for example, by a delayed onset of clinical symptoms of thedisease in a susceptible subject, a reduction in severity of some or allclinical symptoms of the disease, a slower progression of the disease, areduction in the number of relapses of the disease, an improvement inthe overall health or well-being of the subject, or by other parameterswell known in the art that are specific to the particular disease.

Isolated: An “isolated” microorganism (such as a virus, bacterium,fungus, or protozoan) has been substantially separated or purified awayfrom microorganisms of different types, strains, or species.Microorganisms can be isolated by a variety of techniques, includingserial dilution and culturing.

An “isolated” biological component (such as a nucleic acid molecule,protein or organelle) has been substantially separated or purified awayfrom other biological components in the cell of the organism in whichthe component naturally occurs, such as other chromosomal andextra-chromosomal DNA and RNA, proteins, and organelles. Nucleic acidsand proteins that have been “isolated” include nucleic acids andproteins purified by standard purification methods. The term alsoembraces nucleic acids and proteins prepared by recombinant expressionin a host cell, as well as chemically synthesized nucleic acids orproteins, or fragments thereof.

Linker: A “chemical arm” between the protein, polypeptide or label and adrug or drug derivative. As one skilled in the art will recognize, toaccomplish the requisite chemical structure, each of the reactants mustcontain the necessary reactive groups. Representative combinations ofsuch groups are amino with carboxyl to form amide linkages, or carboxywith hydroxy to form ester linkages or amino with alkyl halides to formalkylamino linkages, or thiols with thiols to form disulfides, or thiolswith maleimides or alkylhalides to form thioethers. Obviously, hydroxyl,carboxyl, amino and other functionalities, where not present may beintroduced by known methods. Likewise, as those skilled in the art willrecognize, a wide variety of linking groups may be employed. Thestructure of the linkage should be a stable covalent linkage formed toattach the drug or drug derivative to the protein, polypeptide or label.In some cases the linking group can be designed to be either hydrophilicor hydrophobic in order to enhance the desired binding characteristicsof the ligand and the receptor. The covalent linkages should be stablerelative to the solution conditions under which the ligand and linkinggroup are subjected. Generally preferred linking groups will be from1-20 carbons and 0-10 heteroatoms (NH, O, S) and may be branched orstraight chain. Without limiting the foregoing, it should be obvious toone skilled in the art that only combinations of atoms which arechemically compatible comprise the linking group. For example, amide,ester, thioether, thiol ester, keto, hydroxyl, carboxyl, ether groups incombinations with carbon-carbon bonds are acceptable examples ofchemically compatible linking groups.

Opsonin: A macromolecule that becomes attached to the surface of amicrobe and can be recognized by surface receptors of neutrophils andmacrophages and that increases the efficiency of phagocytosis of themicrobe. Opsonins include IgG antibodies, which are recognized by theFcγ receptor on phagocytes, and fragments of complement proteins, whichare recognized by CR1 (CD35) and by the leukocyte integrin Mac-1.

Opsonophagocytosis: The process of attaching opsonins to microbialsurfaces to target the microbes for phagocytosis. For example, theelicited immune response include opsonophagocytic activity.

PGA: A homopolymer of glutamic acid residues in the L-form or the D-formor a combination thereof.

γPGA: A homopolymer of glutamic acid residues linked by γ peptide bonds.The glutamic acid residues constituting the γPGA homopolymer can besolely in the L-form (γLPGA) or the D-form (γDPGA) or a combinationthereof (γDLPGA).

γDLPGA: A homopolymer of glutamic acid residues which includes acombination of the L-form (γLPGA) and the D-form (γDPGA). In an example,the L-form (γLPGA) and the D-form (γDPGA) are presented at substantiallyequal amounts (40-60% of each of the D- and L-form of γPGA).

Pharmaceutically Acceptable Vehicles: The pharmaceutically acceptablevehicles useful in this disclosure are conventional. Remington'sPharmaceutical Sciences, by E. W. Martin, Mack Publishing Co., Easton,Pa., 15th Edition (1975), describes compositions and formulationssuitable for pharmaceutical delivery of one or more therapeuticcompounds or molecules, such as one or more SARS-CoV nucleic acidmolecules, proteins or antibodies that bind these proteins, andadditional pharmaceutical agents.

In general, the nature of the vehicle will depend on the particular modeof administration being employed. For instance, parenteral formulationsusually comprise injectable fluids that include pharmaceutically andphysiologically acceptable fluids such as water, physiological saline,balanced salt solutions, aqueous dextrose, glycerol or the like as avehicle. For solid compositions (for example, powder, pill, tablet, orcapsule forms), conventional non-toxic solid vehicles can include, forexample, pharmaceutical grades of mannitol, lactose, starch, ormagnesium stearate. In addition to biologically-neutral vehicles,pharmaceutical compositions to be administered can contain minor amountsof non-toxic auxiliary substances, such as wetting or emulsifyingagents, preservatives, and pH buffering agents and the like, for examplesodium acetate or sorbitan monolaurate.

Polypeptide: A polymer in which the monomers are amino acid residueswhich are joined together through amide bonds. When the amino acids arealpha-amino acids, either the L-optical isomer or the D-optical isomercan be used. The terms “polypeptide” or “protein” as used herein areintended to encompass any amino acid sequence and include modifiedsequences such as glycoproteins. The term “polypeptide” is specificallyintended to cover naturally occurring proteins, as well as those whichare recombinantly or synthetically produced.

The term “residue” or “amino acid residue” includes reference to anamino acid that is incorporated into a protein, polypeptide, or peptide.Conservative amino acid substitutions are those substitutions that, whenmade, least interfere with the properties of the original protein, thatis, the structure and especially the function of the protein isconserved and not significantly changed by such substitutions.Conservative substitutions generally maintain (a) the structure of thepolypeptide backbone in the area of the substitution, for example, as asheet or helical conformation, (b) the charge or hydrophobicity of themolecule at the target site, or (c) the bulk of the side chain.

The substitutions which in general are expected to produce the greatestchanges in protein properties will be non-conservative, for instancechanges in which (a) a hydrophilic residue, for example, seryl orthreonyl, is substituted for (or by) a hydrophobic residue, for example,leucyl, isoleucyl, phenylalanyl, valyl or alanyl; (b) a cysteine orproline is substituted for (or by) any other residue; (c) a residuehaving an electropositive side chain, for example, lysyl, arginyl, orhistadyl, is substituted for (or by) an electronegative residue, forexample, glutamyl or aspartyl; or (d) a residue having a bulky sidechain, for example, phenylalanine, is substituted for (or by) one nothaving a side chain, for example, glycine.

Purified: The term “purified” does not require absolute purity; rather,it is intended as a relative term. Thus, for example, a purifiedpeptide, protein, γPGA conjugate, or other active compound is one thatis isolated in whole or in part from naturally associated proteins andother contaminants, in which the peptide, protein, γPGA conjugate, orother active compound is purified to a measurable degree relative to itsnaturally occurring state, for example, relative to its purity within acell extract or chemical synthesis checker.

In certain embodiments, the term “substantially purified” refers to apeptide, protein, γPGA conjugate, or other active compound that has beenisolated from a cell, cell culture medium, or other crude preparationand subjected to fractionation to remove various components of theinitial preparation, such as proteins, cellular debris, and othercomponents. Such purified preparations can include materials in covalentassociation with the active agent, such as glycoside residues ormaterials admixed or conjugated with the active agent, which may bedesired to yield a modified derivative or analog of the active agent orproduce a combinatorial therapeutic formulation, conjugate, fusionprotein or the like. The term purified thus includes such desiredproducts as peptide and protein analogs or mimetics or otherbiologically active compounds wherein additional compounds or moietiesare bound to the active agent in order to allow for the attachment ofother compounds and/or provide for formulations useful in therapeutictreatment or diagnostic procedures.

Generally, substantially purified peptides, proteins, γPGA conjugates,or other active compounds include more than 80% of all macromolecularspecies present in a preparation prior to admixture or formulation ofthe respective compound with additional ingredients in a completepharmaceutical formulation for therapeutic administration. Additionalingredients can include a pharmaceutical carrier, excipient, buffer,absorption enhancing agent, stabilizer, preservative, adjuvant or otherlike co-ingredients. More typically, the peptide, protein, γPGAconjugate or other active compound is purified to represent greater than90%, often greater than 95% of all macromolecular species present in apurified preparation prior to admixture with other formulationingredients. In other cases, the purified preparation may be essentiallyhomogeneous, wherein other macromolecular species are less than 1%.

Recombinant Nucleic Acid: A nucleic acid sequence that is not naturallyoccurring or has a sequence that is made by an artificial combination oftwo otherwise separated segments of sequence. This artificialcombination is often accomplished by chemical synthesis or, morecommonly, by the artificial manipulation of isolated segments of nucleicacids, for example, by genetic engineering techniques such as thosedescribed in Sambrook et al. (ed.), Molecular Cloning: A LaboratoryManual, 2^(nd) ed., vol. 1-3, Cold Spring Harbor Laboratory Press, ColdSpring Harbor, N.Y., 1989. The term recombinant includes nucleic acidsthat have been altered solely by addition, substitution, or deletion ofa portion of the nucleic acid.

Specific Binding Agent: A “specific binding agent” is an agent thatbinds substantially only to a defined target. Thus a protein-specificbinding agent binds substantially only the defined protein, or to aspecific region within the protein. As used herein, “specific bindingagent” includes antibodies and other agents that bind substantially to aspecified polypeptide. The antibodies may be monoclonal or polyclonalantibodies that are specific for the polypeptide, as well asimmunologically effective portions (“fragments”) thereof.

The determination that a particular agent binds substantially only to aspecific polypeptide may readily be made by using or adapting routineprocedures. One suitable in vitro assay makes use of the Westernblotting procedure (described in many standard texts, including Harlowand Lane, Using Antibodies: A Laboratory Manual, CSHL, New York, 1999).

Staphylococci: Staphylococci are gram-positive spherical bacteria thatoccur in microscopic clusters and produce exotoxins. In 1884, Rosenbachdescribed two pigmented colony types of staphylococci and proposed theappropriate nomenclature: Staphylococcus aureus (yellow) andStaphylococcus albus (white). The latter species is now namedStaphylococcus epidermidis. Although more than 20 species ofStaphylococcus exist, only Staphylococcus aureus (S. aureus) andStaphylococcus epidermidis (S epidermidis) are significant in theirinteractions with humans. S. aureus colonizes mainly in the nasalpassages, but it may be found regularly in most other anatomicallocales. S. epidermidis is an inhabitant of the skin and mucous membraneof warm-blooded animals.

S. aureus forms a fairly large yellow colony on rich medium. Bycomparison, S. epidermidis forms a relatively small white colony. S.aureus is often hemolytic on blood agar while S. epidermidis isnon-hemolytic. Staphylococci are facultative anaerobes that grow byaerobic respiration or by fermentation that yields principally lacticacid. The bacteria are catalase-positive and oxidase-negative. S. aureuscan grow at a temperature range of 15 to 45° C. and at NaClconcentrations as high as 15 percent. Nearly all strains of S. aureusproduce the enzyme coagulase. In contrast, nearly all strains of S.epidermidis lack this enzyme. Thus, strains of S. epidermidis are oftenreferred to as coagulase-negative staphylococci.

Although most strains of S. epidermidis are nonpathogenic and may evenplay a protective role in their host as normal flora, S. epidermidis hasbecome the most prevalent pathogen involved in hospital-acquiredinfections. For example, this member of the coagulase-negative group ofstaphylococci can cause severe infection after penetration of theepidermal protective barriers of the human body. Further, it isfrequently resistant to common antibiotics (Vuong, C., and Otto, M.Microbes Infect. 4:481-489, 2002).

Therapeutically Effective Amount: A quantity of a specified agentsufficient to achieve a desired effect in a subject being treated withthat agent. For example, this may be the amount of a γPGA conjugateuseful in increasing resistance to, preventing, ameliorating, and/ortreating infection and disease caused by a coagulase-negativeStaphylococcus, and/or a γPGA expressing Staphylococcus, such as a S.epidermidis infection in a subject. Ideally, a therapeutically effectiveamount of an agent is an amount sufficient to increase resistance to,prevent, ameliorate, and/or treat infection and disease such as iscaused by S. epidermidis infection in a subject without causing asubstantial cytotoxic effect in the subject. The effective amount of anagent useful for increasing resistance to, preventing, ameliorating,and/or treating infection and disease in a subject will be dependent onthe subject being treated, the severity of the affliction, and themanner of administration of the therapeutic composition.

Toxoid: A nontoxic derivative of a bacterial exotoxin produced, forexample, by formaldehyde or other chemical treatment. Toxoids are usefulin the formulation of immunogenic compositions because they retain mostof the antigenic properties of the toxins from which they were derived.

III. Description of Several Embodiments

Coagulase-negative staphylococci, including the species S. epidermidis,are the to predominant cause of hospital-acquired infections. Treatmentis especially difficult owing to biofilm formation and frequentantibiotic resistance. Further, virulence mechanisms of these importantopportunistic pathogens have remained poorly characterized.

The present disclosure provides important novel biological functions forγPGA and demonstrates that γPGA (such as γDLPGA) is an excellent targetfor drugs or vaccines aimed at preventing and/or treating disease causedby S. epidermidis and related staphylococci pathogens. Notably, γDLPGAwas synthesized by all tested strains of S. epidermidis and a series ofclosely related coagulase-negative staphylococci, most of which areopportunistic pathogens. Although PGA has a generally lowimmunogenicity, recent studies have shown that anti-PGA antibodiesefficiently protect from anthrax infection in animal models (Leppla, S.H., Robbins, J. B., Schneerson, R., and Shiloach, J. J. Clin. Invest.110: 141-144, 2002; Schneerson, R., et al. Proc. Natl. Acad. Sci. U.S.A.100: 8945-8950, 2003; Kozel T. R., et al. Proc. Natl. Acad. Sci. U.S.A.101: 5042-5047, 2003; and Rhie, G. E., et al. Proc. Natl. Acad. Sci.U.S.A. 100: 10925-10930, 2003). The present studies indicate thatanti-PGA antibodies (such as antibodies produced by an immunogeniccomposition) are valuable for the treatment of chronic infections by S.epidermidis and certain other pathogenic staphylococci. Hence antiseracontaining a therapeutically effective amount of these antibodies can beadministered to a subject to treat the infection, or an immune responseagainst the target can be stimulated to provide a similar antimicrobialeffect. In particular embodiments, the antibodies are directed againstγDLPGA.

A. Staphylococcus γPGA Polypeptide Polypeptides and Conjugates

Staphylococcus capsular γPGA polypeptide conjugates are disclosed, asare Staphylococcus capsular γPGA polypeptides that include, but are notlimited to, γDLPGA polypeptides. However in all examples throughout,γDLPGA can be substituted for γPGA. Further, in all examples throughout,Staphylococcus can be substituted with S. epidermidis, S. capitis, S.warneri, S. saccharolyticus, S. caprae, S. hominis, S. haemolyticus, S.lugdunensis, S. simulans or S. epidermidis. The present disclosureprovides compositions that comprise or consist or consist essentially ofγPGA polypeptides (such as γDLPGA polypeptides) or antibodies againstthese polypeptides (such as antisera). The polypeptides or antisera canbe provided in substantially purified forms, for example at least 90% or95% of the composition comprises the polypeptide or antisera. In certainexamples at least 90% or 95% of the composition comprises γDLPGApolypeptides or antisera against it. The compositions may also include apharmaceutical vehicle and/or an adjuvant.

γPGA is an anionic, extracellular polymer, in which the α-amino andγ-carboxy groups of D- or L-glutamic acid are linked by isopeptidebonds. Staphylococcus produces γPGA as a mixture of both the D- andL-forms (see FIG. 2C), whereas other bacilli such as B. anthracis havebeen previously noted to produce exclusively γDPGA. In one embodiment,the γPGA conjugates disclosed herein are γLPGA conjugates. In anotherembodiment, the γPGA conjugates are γDPGA conjugates. In a furtherembodiment, the γPGA conjugates are mixtures of γLPGA conjugates andγDPGA conjugates (a γDLPGA conjugate). For example, the γLPGA conjugatesand γDPGA are present in substantially equal amounts in certaincompositions. In an embodiment, substantially equal amounts can includeapproximately fifty percent of each isoform±approximately twentypercent, that is, about 30% to 70% of one or the other.

Staphylococcus capsular γPGA polypeptides can be isolated and purifiedby many methods well known in the art, such as salt fractionation,phenol extraction, precipitation with organic solvents (for example,hexadecyltrimethylammonium bromide (cetavlon) or ethanol), affinitychromatography, ion-exchange chromatography, hydrophobic chromatography,high performance liquid chromatography, gel filtration, isoelectricfocusing, and the like. In one specific, non-limiting example, capsularγDLPGA polypeptides are extracted from the culture supernatant ofgrowing bacilli by acid precipitation. (Kocianova, C. et al. J. Clin.Invest. 115: 688-694, 2005). The presence of extracted γPGA polypeptidesis confirmed by methods well known in the art, including immuno-dot blotassays. Further, enantiomeric confirmations of the γPGA polypeptides aredetermined by stereoselective chromatography and liquidchromatographic-mass spectrometric detection of glutamic acid.

It is contemplated that synthetic γPGA polypeptides of varying lengths(for example, about 5, 10, 15, or 20 residues) havin_(g) either or bothof the D- or L-configuration can be readily synthesized by automatedsolid phase procedures well known in the art. Suitable syntheses can beperformed by utilizing “T-boc” or “F-moc” procedures. Techniques andprocedures for solid phase synthesis are described in Solid PhasePeptide Synthesis: A Practical Approach, by E. Atherton and R. C.Sheppard, published by IRL, Oxford University Press, 1989. In specific,non-limiting examples, the synthetic γPGA polypeptide includes about 1to about 20 glutamic acid residues, such as about 10 to about 15glutamic acid residues, or about 10 glutamic acid residues. Thecompositions and purity of synthetic γPGA polypeptides can be determinedby GLC-MS and matrix-assisted laser desorption ionization time-of-flight(MALDI-TOF) spectrometry.

In an embodiment, the conjugate includes a Staphylococcus capsularγDLPGA polypeptide linked to a carrier. Carriers for linking to γPGApolypeptides as disclosed herein are chosen to increase theimmunogenicity of the γPGA polypeptides and/or to elicit antibodiesagainst the carrier which are diagnostically, analytically, and/ortherapeutically beneficial. Covalent linking of γPGA polypeptides to acarrier confers enhanced immunogenicity and T-cell dependence of theresultant immune response. Useful carriers include polymeric carriers,which can be natural, semi-synthetic or synthetic materials containingone or more functional groups, for example primary and/or secondaryamino groups, azido groups; hydroxyl groups, or carboxyl groups, towhich a reactant moiety can be attached. The carrier can be watersoluble or insoluble, and in some embodiments is a protein orpolypeptide. Carriers that fulfill these criteria are generally known inthe art (see, for example, Fattom et al., Infect. Immun. 58:2309-12,1990; Devi et al., PNAS 88:7175-79, 1991; Szu et al., Infect. Immun.59:4555-61, 1991; Szu et al., J. Exp. Med. 166:1510-24, 1987; andPavliakova et al., Infect. Immun. 68:2161-66, 2000).

Specific, non-limiting examples of water soluble polypeptide carriersinclude, but are not limited to, natural, semi-synthetic or syntheticpolypeptides or proteins from bacteria or viruses. In one embodiment,bacterial products for use as carriers include bacterial wall proteinsand other products (for example, LPS of Gram-negative bacteria), andsoluble antigens of bacteria. In another embodiment, bacterial productsfor use as carriers include bacterial toxin or toxiods derivedtherefrom. Bacterial toxins include bacterial products that mediatetoxic effects, inflammatory responses, stress, shock, chronic sequelae,or mortality in a susceptible host. Specific, non-limiting examples ofbacterial toxins include, but are not limited to: B. anthracis PA (forexample, as encoded by bases 143779 to 146073 of GenBank Accession No.NC 007322, herein incorporated by reference as listed on Jul. 10, 2006)and variants of PA that share at least 90%, at least 95%, or at least98% amino acid sequence homology to this reference PA, fragments thereofthat contain at least one antigenic epitope, and analogs or derivativescapable of eliciting an immune response; B. anthracis LF (for example,as encoded by the complement of bases 149357 to 151786 of GenBankAccession No. NC 007322 herein incorporated by reference as listed onJul. 10, 2006); bacterial toxins and toxoids, such as tetanustoxin/toxoid (for example, as described in U.S. Pat. Nos. 5,601,826 and6,696,065); diphtheria toxin/toxoid (for example, as described in U.S.Pat. Nos. 4,709,017 and 6,696,065); P. aeruginosa exotoxin/toxoid/ (forexample, as described in U.S. Pat. Nos. 4,428,931, 4,488,991 and5,602,095); pertussis toxin/toxoid (for example, as described in U.S.Pat. Nos. 4,997,915, 6,399,076 and 6,696,065); and C. perfringensexotoxin/toxoid (for example, as described in U.S. Pat. Nos. 5,817,317and 6,403,094). Viral proteins, such as hepatitis B surface antigen (forexample, as described in U.S. Pat. Nos. 5,151,023 and 6,013,264) andcore antigen (for example, as described in U.S. Pat. Nos. 4,547,367 and4,547,368) can also be used as carriers, as well as proteins from higherorganisms such as keyhole limpet hemocyanin, horseshoe crab hemocyanin,edestin, mammalian serum albumins, and mammalian immunoglobulins.

In addition to bacterial and viral products, polysaccharide carriers canalso be useful in preparing the γPGA polypeptide conjugates as disclosedherein. Polysaccharide carriers include, but are not limited to,dextran, capsular polysaccharides from microorganisms such as the Vicapsular polysaccharide from S. typhi (see, for example, U.S. Pat. No.5,204,098); Pneumococcus group 12 (12F and 12A) polysaccharides;Haemophilus influenzae type d polysaccharide; and certain plant, fruit,and synthetic oligo- or polysaccharides which are immunologicallysimilar to capsular polysaccharides, such as pectin, D-galacturonan,oligogalacturonate, or polygalacturonate (for example, as described inU.S. Pat. No. 5,738,855).

Specific, non-limiting examples of water insoluble carriers useful inpreparing the γPGA polypeptide conjugates as disclosed herein include,but are not limited to, aminoalkyl agarose (for example, aminopropyl oraminohexyl SEPHAROSE; Pharmacia Inc., Piscataway, N.J.), aminopropylglass, cross-linked dextran, and the like, to which a reactive moietycan be attached. Other carriers can be used, provided that a functionalgroup is available for covalently attaching a reactive group.

Binding of γPGA polypeptides to a carrier can be direct or via a linkerelement. Linkers can include amino acids, including amino acids capableof forming disulfide bonds, but can also include other molecules suchas, for example, polysaccharides or fragments thereof. Linkers can bechosen so as to elicit their own immunogenic effect which may be eitherthe same, or different, than that elicited by the γPGA polypeptidesand/or carriers disclosed herein. For example, such linkers can bebacterial antigens which elicit the production of antibodies to aninfectious bacteria. In such instances, for example, the linker can be aprotein or protein fragment of an infectious bacterium.

The covalent linking of the γPGA polypeptides to the carrier can becarried out in any manner well known to one of skill in the art.Conjugation methods applicable to the present disclosure include, by wayof non-limiting example, reductive amination, diazo coupling, thioetherbond, disulfide bond, amidation and thiocarbamoyl chemistries. In oneembodiment, the γPGA polypeptides and/or the carrier are “activated”prior to conjugation or linking. Activation provides the necessarychemical groups for the conjugation reaction to occur. In one specific,non-limiting example, the activation step includes derivatization withadipic acid dihydrazide (ADH). In another specific, non-limitingexample, the activation step includes derivatization with theN-hydroxysuccinimide ester of 3-(2-pyridyl dithio)-propionic acid(SPDP). In yet another specific, non-limiting example, the activationstep includes derivatization with succinimidyl 3-(bromoacetamido)propionate (SBAP). Further, non-limiting examples of derivatizing agentsinclude succinimidylformylbenzoate (SFB) and succinimidyllevulinate(SLV).

Following conjugation of a γPGA polypeptide to a carrier, the γPGApolypeptide-carrier conjugate can be purified by a variety of techniqueswell known to one of skill in the art. One goal of the purification stepis to remove unbound γPGA polypeptide from the γPGA polypeptide-carrierconjugate. One method for purification, involving ultrafiltration in thepresence of ammonium sulfate, is described in U.S. Pat. No. 6,146,902.Alternatively, γPGA polypeptide-carrier conjugates can be purified awayfrom unreacted γPGA polypeptide and carrier by any number of standardtechniques including, for example, size exclusion chromatography,density gradient centrifugation, hydrophobic interaction chromatography,or ammonium sulfate fractionation. See, for example, Anderson et al., J.Immunol. 137:1181-86, 1986 and Jennings & Lugowski, J. Immunol.127:1011-18, 1981. The compositions and purity of the conjugates can bedetermined by GLC-MS and MALDI-TOF spectrometry.

For γPGA conjugates or compositions including γPGA polypeptides bound atone point to a carrier, complex structural characteristics can be usedto determine optimal immunogenicity for synthetic conjugates (see, forexample, Kabat, Prog. Immunol. 5:67-85, 1983; Pozsgay et al., PNAS96:5194-97, 1999; Lee et al., J. Immunol. 116:1711-18, 1976; and Dintziset al., PNAS 73:3671-75, 1976). γPGA polypeptide lengths must besufficient to occupy a cognate antibody combining site. In addition, thedensity of the γPGA polypeptide on the carrier influences the ability ofthe γPGA conjugate to form both aggregates with the surface Ig receptor,and to permit interaction of the carrier fragments with T-cells. Forexample, γPGA conjugates having a density of γPGA polypeptide chains tocarrier molecule of between about 5:1 to about 32:1, respectively, suchas about 8:1 to about 22:1, or about 10:1 to about 15:1, arecontemplated to be useful within the immunogenic compositions andmethods described herein.

In an embodiment, an immunogenic composition may include Bacilluscapsular γPGA polypeptide covalently linked to a carrier in combinationwith or in lieu of Staphylococcus capsular γPGA polypeptide and anadjuvant. For example, the immunogenic composition may include aBacillus capsular γPGA polypeptide covalently linked to a carrier asdisclosed in WO 2005/000884 A1, published Jan. 6, 2005, which isincorporated herein by reference in its entirety.

The disclosed immune conjugates can elicit immune responses in asubject. For example, the immune response may include opsonophagocyticactivity. Further, the conjugates or other therapeutic compositions canbe administered to a subject who has been diagnosed with acoagulase-negative staphylococcus-induced infection, such as an S.epidermidis infection, for example a subject in whom a diagnosis hasbeen made by laboratory culture. Alternatively the subject may be onewho is at risk of such an infection, for example a hospitalized subjectwith an in-dwelling device, such as a catheter. The therapeutic effectof the disclosed compositions can either inhibit the development orprogression of the infection, hence they can be administered eitherprophylactically or to treat an existing infection.

B. Specific Binding Agents

The disclosure contemplates use of specific binding agents that bind aγPGA polypeptide of Staphylococcus, or a γPGA conjugate (for example aγDLPGA conjugate) as disclosed herein. The binding agent can be used topurify and detect the γPGA polypeptides, as well as for detection anddiagnosis of Staphylococcus infections. Further, the binding agent canbe used to treat a Staphylococcus infection such as by treating asubject with an antiserum against γPGA, such as an antiserum againstγDLPGA. Examples of the binding agents include a polyclonal ormonoclonal antibody (including humanized monoclonal antibody), andfragments thereof, that bind to any of the γPGA polypeptides or γPGAconjugates disclosed herein such as γDLPGA.

Monoclonal or polyclonal antibodies can be raised to recognize thetarget, such as γPGA polypeptide and/or conjugate as described herein,or an analog or derivative thereof. Substantially pure conjugatesuitable for use as immunogen can be prepared as described above.Monoclonal or polyclonal antibodies to the conjugate can then beprepared.

Monoclonal antibodies to the polypeptides can be prepared from murinehybridomas according to the classic method of Kohler & Milstein (Nature256:495-97, 1975), or a derivative method thereof. Briefly, a mouse isrepetitively inoculated with a few micrograms of the selected immunogen(for example, a γPGA conjugate) over a period of a few weeks. The mouseis then sacrificed, and the antibody-producing cells of the spleenisolated. The spleen cells are fused by means of polyethylene glycolwith mouse myeloma cells, and the excess unfused cells destroyed bygrowth of the system on selective media comprising aminopterin (HATmedia). The successfully fused cells are diluted and aliquots of thedilution placed in wells of a microtiter plate where growth of theculture is continued. Antibody-producing clones are identified bydetection of antibody in the supernatant fluid of the wells byimmunoassay procedures, such as the enzyme-linked immunoabsorbent assay(ELISA), as originally described by Engvall (Meth. Enzymol., 70:419-39,1980), or a derivative method thereof. Selected positive clones can beexpanded and their monoclonal antibody product harvested for use.Detailed procedures for monoclonal antibody production are described inHarlow and Lane, Using Antibodies: A Laboratory Manual, CSHL, New York,1999. Polyclonal antiserum containing antibodies can be prepared byimmunizing suitable animals with an immunogen comprising a γPGAconjugate.

Effective antibody production (whether monoclonal or polyclonal) isaffected by many factors related both to the antigen and the hostspecies. For example, small molecules tend to be less immunogenic thanothers and may require the use of carriers and adjuvant. Also, hostanimals vary in response to site of inoculations and dose, with eitherinadequate or excessive doses of antigen resulting in low titerantisera. Small doses (ng level) of antigen administered at multipleintradermal sites appear to be most reliable. An effective immunizationprotocol for rabbits can be found in Vaitukaitis et al. (J. Clin.Endocrinol. Metab., 33:988-91, 1971).

Booster injections can be given at regular intervals, and antiserumharvested when the antibody titer thereof, as determinedsemi-quantitatively, for example, by double immunodiffusion in agaragainst known concentrations of the antigen, begins to fall. See, forexample, Ouchterlony et al., Handbook of Experimental Immunology, Wier,D. (ed.), Chapter 19, Blackwell, 1973. A plateau concentration ofantibody is usually in the range of 0.1 to 0.2 mg/ml of serum (about 12μM). Affinity of the antisera for the antigen is determined by preparingcompetitive binding curves, as described, for example, by Fisher (Manualof Clinical Immunology, Ch. 42, 1980).

Antibodies can be contained in blood plasma, serum, hybridomasupernatants and the like. Alternatively, the antibodies can be isolatedto the extent desired by well known techniques in the art, such as, ionexchange chromatography, sizing chromatography, or affinitychromatography. The antibodies can be purified so as to obtain specificclasses or subclasses of antibody, such as IgM, IgG, IgA, IgG1, IgG2,IgG3, IgG4 and the like. Antibodies of the IgG class are of use forpurposes of passive protection.

Antibody fragments can be used in place of whole antibodies and can bereadily expressed in prokaryotic host cells. Methods of making and usingimmunologically effective portions of monoclonal antibodies, alsoreferred to as “antibody fragments,” are well known and include thosedescribed in Better & Horowitz (Methods Enzymol. 178:476-96, 1989;Glockshuber et al., Biochemistry 29:1362-67, 1990) and U.S. Pat. Nos.5,648,237; 4,946,778; and 5,455,030. Conditions whereby apolypeptide/binding agent complex can form, as well as assays for thedetection of the formation of a polypeptide/binding agent complex andquantitation of binding affinities of the binding agent and polypeptide,are standard in the art. Such assays can include, but are not limitedto, Western blotting, immunoprecipitation, immunofluorescence,immunocytochemistry, immunohistochemistry, fluorescence activated cellsorting, fluorescence in situ hybridization, immunomagnetic assays,ELISA, ELISPOT (Coligan et al., Current Protocols in Immunology, Wiley,NY, 1995), agglutination assays, flocculation assays, cell panning, andthe like, as are well known to one of skill in the art.

The γPGA antibodies or antibody fragments disclosed herein can have anumber of diagnostic and therapeutic uses. For example, the antibodiesor antibody fragments can be used for passive immunotherapy, such as byadministering to a subject a therapeutically effective amount of theantibody or antibody fragments. In another example, the antibodies orantibody fragments can be used as in vitro diagnostic agents in variousimmunoassays to test for the presence of Staphylococcus expressing aγPGA polypeptide in biological (for example, clinical) samples or onsurfaces such as an in-dwelling device surface. Useful immunoassaysinclude, but are not limited to, agglutination assays,radioimmunoassays, ELISA, fluorescence assays, Western blots and thelike. In one such assay, for example, the biological sample is contactedfirst with an antibody which binds Staphylococcus γPGA polypeptide, andthen with a labeled second antibody to detect the presence of aStaphylococcus, to which the first antibody has bound. Such assays canbe, for example, of direct format (where a labeled first antibody isreactive with the γDLPGA polypeptide), an indirect format (where alabeled second antibody is reactive with the first antibody), acompetitive format (such as the addition of a labeled γDLPGApolypeptide), or a sandwich format (where both labeled and unlabelledantibody are utilized), as well as other formats well known to one ofskill in the art.

Binding agents of this disclosure can be bound to a substrate (forexample, beads, tubes, slides, plates, nitrocellulose sheets, and thelike) or conjugated with a detectable moiety, or both bound andconjugated. The detectable moieties contemplated for the presentdisclosure can include, but are not limited to, an immunofluorescentmoiety (for example, fluorescein, rhodamine), a radioactive moiety (forexample, ³²P, ¹²⁵I, ³⁵ S), an enzyme moiety (for example, horseradishperoxidase, alkaline phosphatase), a colloidal gold moiety, and a biotinmoiety. Such conjugation techniques are standard in the art (forexample, see Harlow and Lane, Using Antibodies: A Laboratory Manual,CSHL, New York, 1999; Yang et al., Nature, 382:319-24, 1996).

D. Pharmaceutical and Immunogenic Compositions and Uses Thereof

Pharmaceutical compositions (including therapeutic and prophylacticformulations) of a γPGA conjugate are also encompassed by the presentdisclosure, and include a γDLPGA conjugate and/or other biologicallyactive agent as described herein, typically combined together with oneor more pharmaceutically acceptable vehicles and, optionally, othertherapeutic ingredients (for example, antibiotics, oranti-inflammatories).

Within the pharmaceutical compositions and methods of the disclosure,the conjugate and/or other biologically active agent can be administeredto subjects by a variety of mucosal administration modes, including byoral, rectal, intranasal, intrapulmonary, or transdermal delivery, or bytopical delivery to other surfaces. Optionally, the conjugate and/orother active agent can be administered by non-mucosal routes, includingby intramuscular, subcutaneous, intravenous, intra-atrial,intra-articular, intraperitoneal, or parenteral routes. In otherembodiments, the conjugate and/or other active agent can be administeredex vivo such as directly to an in-dwelling medical device.

To formulate pharmaceutical compositions of the present disclosure, theconjugate and/or other biologically active agent can be combined withvarious pharmaceutically acceptable additives, as well as a base orvehicle for dispersion of the conjugate and/or other biologically activeagent. Desired additives include, but are not limited to, pH controlagents, such as arginine, sodium hydroxide, glycine, hydrochloric acid,citric acid, and the like. In addition, local anesthetics (for example,benzyl alcohol), isotonizing agents (for example, sodium chloride,mannitol, sorbitol), adsorption inhibitors (for example, Tween 80),solubility enhancing agents (for example, cyclodextrins and derivativesthereof), stabilizers (for example, serum albumin), and reducing agents(for example, glutathione) can be included. Adjuvants, such as aluminumhydroxide (for example, Amphogel, Wyeth Laboratories, Madison, N.J.),Freund's adjuvant, MPL™ (3-O-deacylated monophosphoryl lipid A; Corixa,Hamilton Ind.) and IL-12 (Genetics Institute, Cambridge Mass.), amongmany other suitable adjuvants well known in the art, can be included inthe compositions. When the composition is a liquid, the tonicity of theformulation, as measured with reference to the tonicity of 0.9% (w/v)physiological saline solution taken as unity, is typically adjusted to avalue at which no substantial, irreversible tissue damage will beinduced at the site of administration. Generally, the tonicity of thesolution is adjusted to a value of about 0.3 to about 3.0, such as about0.5 to about 2.0, or about 0.8 to about 1.7.

The disclosed conjugate and/or other biologically active agent can bedispersed in a base or vehicle, which can include a hydrophilic compoundhaving a capacity to disperse the conjugate and/or other biologicallyactive agent, and any desired additives. The base can be selected from awide range of suitable compounds, including but not limited to,copolymers of polycarboxylic acids or salts thereof, carboxylicanhydrides (for example, maleic anhydride) with other monomers (forexample, methyl (meth)acrylate, acrylic acid and the like), hydrophilicvinyl polymers, such as polyvinyl acetate, polyvinyl alcohol,polyvinylpyrrolidone, cellulose derivatives, such ashydroxymethylcellulose, hydroxypropylcellulose and the like, and naturalpolymers, such as chitosan, collagen, sodium alginate, gelatin,hyaluronic acid, and nontoxic metal salts thereof. Often, abiodegradable polymer is selected as a base or vehicle, for example,polylactic acid, poly(lactic acid-glycolic acid) copolymer,polyhydroxybutyric acid, poly(hydroxybutyric acid-glycolic acid)copolymer and mixtures thereof. Alternatively or additionally, syntheticfatty acid esters such as polyglycerin fatty acid esters, sucrose fattyacid esters and the like can be employed as vehicles. Hydrophilicpolymers and other vehicles can be used alone or in combination, andenhanced structural integrity can be imparted to the vehicle by partialcrystallization, ionic bonding, cross-linking and the like. The vehiclecan be provided in a variety of forms, including, fluid or viscoussolutions, gels, pastes, powders, microspheres and films for directapplication to a mucosal surface.

The conjugate and/or other biologically active agent can be combinedwith the base or vehicle according to a variety of methods, and releaseof the conjugate and/or other biologically active agent can be bydiffusion, disintegration of the vehicle, or associated formation ofwater channels. In some circumstances, the conjugate and/or otherbiologically active agent is dispersed in microcapsules (microspheres)or nanocapsules (nanospheres) prepared from a suitable polymer, forexample, isobutyl 2-cyanoacrylate (see, for example, Michael et al., J.Pharmacy Pharmacol. 43:1-5, 1991), and dispersed in a biocompatibledispersing medium, which yields sustained delivery and biologicalactivity over a protracted time. In other embodiments the active agentis provided in a substantially pure form, excluding other componentsusually found in bacteria. The active agent may be at least 50%, 75%,90% or 95% pure, in that it is purified from a naturally occurringbiological background.

The compositions of the disclosure can alternatively contain aspharmaceutically acceptable vehicles substances as required toapproximate physiological conditions, such as pH adjusting and bufferingagents, tonicity adjusting agents, wetting agents and the like, forexample, sodium acetate, sodium lactate, sodium chloride, potassiumchloride, calcium chloride, sorbitan monolaurate, and triethanolamineoleate. For solid compositions, conventional nontoxic pharmaceuticallyacceptable vehicles can be used which include, for example,pharmaceutical grades of mannitol, lactose, starch, magnesium stearate,sodium saccharin, talcum, cellulose, glucose, sucrose, magnesiumcarbonate, and the like.

Pharmaceutical compositions for administering the γPGA conjugate,polypeptide or antisera (such as the γDLPGA conjugate, polypeptide orantisera) and/or other biologically active agent can also be formulatedas a solution, microemulsion, or other ordered structure suitable forhigh concentration of active ingredients. The vehicle can be a solventor dispersion medium containing, for example, water, ethanol, polyol(for example, glycerol, propylene glycol, liquid polyethylene glycol,and the like), and suitable mixtures thereof. Proper fluidity forsolutions can be maintained, for example, by the use of a coating suchas lecithin, by the maintenance of a desired particle size in the caseof dispersible formulations, and by the use of surfactants. In manycases, it will be desirable to include isotonic agents, for example,sugars, polyalcohols, such as mannitol and sorbitol, or sodium chloridein the composition. Prolonged absorption of the conjugate and/or otherbiologically active agent can be brought about by including in thecomposition an agent which delays absorption, for example, monostearatesalts and gelatin.

In certain embodiments, the agent can be administered in a time releaseformulation, for example in a composition which includes a slow releasepolymer. These compositions can be prepared with vehicles that willprotect against rapid release, for example a controlled release vehiclesuch as a polymer, microencapsulated delivery system or bioadhesive gel.Prolonged delivery in various compositions of the disclosure can bebrought about by including in the composition agents that delayabsorption, for example, aluminum monostearate hydrogels and gelatin.When controlled release formulations are desired, controlled releasebinders suitable for use in accordance with the disclosure include anybiocompatible controlled release material which is inert to the activeagent and which is capable of incorporating the conjugate and/or otherbiologically active agent. Numerous such materials are known in the art.Useful controlled-release binders are materials that are metabolizedslowly under physiological conditions following their delivery (forexample, at a mucosal surface, or in the presence of bodily fluids).Appropriate binders include, but are not limited to, biocompatiblepolymers and copolymers well known in the art for use in sustainedrelease formulations. Such biocompatible compounds are non-toxic andinert to surrounding tissues, and do not trigger significant adverseside effects, such as nasal irritation, immune response, inflammation,or the like. They are metabolized into metabolic products that are alsobiocompatible and easily eliminated from the body.

Exemplary polymeric materials include, but are not limited to, polymericmatrices derived from copolymeric and homopolymeric polyesters havinghydrolyzable ester linkages. A number of these are known in the art tobe biodegradable and to lead to degradation products having no or lowtoxicity. Exemplary polymers include polyglycolic acids and polylacticacids, poly(DL-lactic acid-co-glycolic acid), poly(D-lacticacid-co-glycolic acid), and poly(L-lactic acid-co-glycolic acid). Otheruseful biodegradable or bioerodable polymers include, but are notlimited to, such polymers as poly(epsilon-caprolactone),poly(epsilon-aprolactone-CO-lactic acid),poly(epsilon.-aprolactone-CO-glycolic acid), poly(beta-hydroxy butyricacid), poly(alkyl-2-cyanoacrilate), hydrogels, such as poly(hydroxyethylmethacrylate), polyamides, poly(amino acids) (for example, L-leucine,glutamic acid, L-aspartic acid and the like), poly(ester urea),poly(2-hydroxyethyl DL-aspartamide), polyacetal polymers,polyorthoesters, polycarbonate, polymaleamides, polysaccharides, andcopolymers thereof. Many methods for preparing such formulations arewell known to those skilled in the art (see, for example, Sustained andControlled Release Drug Delivery Systems, J. R. Robinson, ed., MarcelDekker, Inc., New York, 1978). Other useful formulations includecontrolled-release microcapsules (U.S. Pat. Nos. 4,652,441 and4,917,893), lactic acid-glycolic acid copolymers useful in makingmicrocapsules and other formulations (U.S. Pat. Nos. 4,677,191 and4,728,721) and sustained-release compositions for water-soluble peptides(U.S. Pat. No. 4,675,189).

The pharmaceutical compositions of the disclosure typically are sterileand stable under conditions of manufacture, storage and use. Sterilesolutions can be prepared by incorporating the conjugate and/or otherbiologically active agent in the required amount in an appropriatesolvent with one or a combination of ingredients enumerated herein, asrequired, followed by filtered sterilization. Generally, dispersions areprepared by incorporating the conjugate and/or other biologically activeagent into a sterile vehicle that contains a basic dispersion medium andthe required other ingredients from those enumerated herein. In the caseof sterile powders, methods of preparation include vacuum drying andfreeze-drying which yields a powder of the γPGA conjugate and/or otherbiologically active agent plus any additional desired ingredient from apreviously sterile-filtered solution thereof. The prevention of theaction of microorganisms can be accomplished by various antibacterialand antifungal agents, for example, parabens, chlorobutanol, phenol,sorbic acid, thimerosal, and the like.

In accordance with the various treatment methods of the disclosure, theactive agent can be delivered to a subject in a manner consistent withconventional methodologies associated with management of the disorderfor which treatment or prevention is sought. In accordance with thedisclosure herein, a prophylactically or therapeutically effectiveamount of the active agent is administered to a subject in need of suchtreatment for a time and under conditions sufficient to prevent,inhibit, and/or ameliorate a selected disease, condition or one or moresymptom(s) thereof. For example, a therapeutically effective amount ofthe active agent is administered to a subject to treat an S. epidermidisinfection.

Typical subjects intended for treatment with the compositions andmethods of the present disclosure include humans, as well as non-humanprimates and other animals. To identify subjects for prophylaxis ortreatment according to the methods of the disclosure, accepted screeningmethods are employed to determine risk factors associated with atargeted or suspected disease of condition (for example, S. epidermidisinfection) as discussed herein, or to determine the status of anexisting disease or condition in a subject. These screening methodsinclude, for example, conventional work-ups to determine environmental,familial, occupational, and other such risk factors that may beassociated with the targeted or suspected disease or condition, as wellas diagnostic methods, such as various ELISA and other immunoassaymethods, which are available and well known in the art to detect and/orcharacterize disease-associated markers. These and other routine methodsallow the clinician to select patients in need of therapy using themethods and pharmaceutical compositions of the disclosure. In accordancewith these methods and principles, the active agents disclosed hereincan be administered according to the teachings herein as an independentprophylaxis or treatment program, or as a follow-up, adjunct orcoordinate treatment regimen to other treatments, including surgery,vaccination, immunotherapy, hormone treatment, cell, tissue, or organtransplants, and the like.

The conjugates can be used in coordinated vaccination protocols orcombinatorial formulations with immunogens to enhance an immune responseelicited by the immunogen alone. In one example, novel combinatorialimmunogenic compositions and coordinated immunization protocols employseparate immunogens or formulations, each directed toward eliciting ananti-immunogen or an anti-γPGA (such as an anti-γDLPGA) immune response.Separate immunogens that elicit the anti-immunogen or anti-γPGA immuneresponse can be combined in a polyvalent immunogenic compositionadministered to a subject in a single immunization step, or they can beadministered separately (in monovalent immunogenic compositions) in acoordinate immunization protocol. Typically, when the anti-immunogen andanti-γPGA immunogens are administered separately, they are administeredcoordinately, in close temporal sequence (for example, the anti-PAimmunogen will be administered hours, one or two days, or within a weekor two, prior to administration of the anti-γPGA immunogen, or viceversa).

The administration of the conjugate and/or other biologically activeagent of the disclosure can be for either prophylactic or therapeuticpurpose. When provided prophylactically, the conjugate and/or otherbiologically active agent is provided in advance of any symptom. Theprophylactic administration of the conjugate and/or other biologicallyactive agent serves to prevent or ameliorate any subsequent infection.When provided therapeutically, the conjugate and/or other biologicallyactive agent is provided at (or shortly after) the onset of a symptom ofdisease or infection. The conjugate and/or other biologically activeagent of the disclosure can thus be provided prior to the anticipatedexposure to S. epidermidis or another Staphylococcus, so as to attenuatethe anticipated severity, duration or extent of an infection and/orassociated disease symptoms, after exposure or suspected exposure to thebacteria, or after the actual initiation of an infection.

For prophylactic and therapeutic purposes, the active agents presentlydisclosed can be administered to the subject in a single bolus delivery,via continuous delivery (for example, continuous transdermal, mucosal orintravenous delivery) over an extended time period, or in a repeatedadministration protocol (for example, by an hourly, daily or weekly,repeated administration protocol). The therapeutically effective dosageof the conjugate and/or other biologically active agent can be providedas repeated doses within a prolonged prophylaxis or treatment regimenthat will yield clinically significant results to alleviate one or moresymptoms or detectable conditions associated with a targeted disease orcondition as set forth herein. Determination of effective dosages inthis context is typically based on animal model studies followed up byhuman clinical trials and is guided by administration protocols thatsignificantly reduce the occurrence or severity of targeted diseasesymptoms or conditions in the subject. Suitable models in this regardinclude, for example, murine, rat, porcine, feline, non-human primate,and other accepted animal model subjects known in the art.Alternatively, effective dosages can be determined using in vitro models(for example, immunologic and histopathologic assays). One advantage tousing in vitro models is only ordinary calculations and adjustments arerequired to determine an appropriate concentration and dose toadminister a therapeutically effective amount of the conjugate and/orother biologically active agent. For example, a therapeuticallyeffective amount is effective to elicit a desired immune response oralleviate one or more symptoms of a targeted disease. In anotherexample, an effective amount or effective dose of the conjugate and/orbiologically active agent may simply inhibit or enhance one or moreselected biological activities correlated with a disease or condition,as set forth herein, for either therapeutic or diagnostic purposes.

The actual dosage of the conjugate and/or other biologically activeagent (such as anti-sera) will vary according to factors such as thedisease indication and particular status of the subject (for example,the subject's age, size, fitness, extent of symptoms, susceptibilityfactors, and the like), time and route of administration, other drugs ortreatments being administered concurrently, as well as the specificpharmacology of the conjugate and/or other biologically active agent foreliciting the desired activity or biological response in the subject.Dosage regimens can be adjusted to provide an optimum prophylactic ortherapeutic response. A therapeutically effective amount is also one inwhich any toxic or detrimental side effects of the γPGA conjugate (suchas the γDLPGA conjugate) and/or other biologically active agent isoutweighed in clinical terms by therapeutically beneficial effects. Anon-limiting range for a therapeutically effective amount of theconjugate and/or other biologically active agent within the methods andformulations of the disclosure is about 0.01 mg/kg body weight to about10 mg/kg body weight, such as about 0.05 mg/kg to about 5 mg/kg bodyweight, or about 0.2 mg/kg to about 2 mg/kg body weight. The antibodiesof the present disclosure will typically be administered in a dosageranging from about 1 mg/kg body weight to about 10 mg/kg body weight ofthe subject, although a lower or higher dose can be administered.

Upon administration of a conjugate or related immunogenic composition ofthe disclosure (for example, via injection, aerosol, oral, topical orother route), the immune system of the subject typically responds to theimmunogenic composition by producing antibodies specific for γPGA and/ora carrier protein. Such a response signifies that an immunologicallyeffective dose of the conjugate or related immunogenic composition wasdelivered. An immunologically effective dosage can be achieved by singleor multiple administrations (including, for example, multipleadministrations per day), daily, or weekly administrations. For eachparticular subject, specific dosage regimens can be evaluated andadjusted over time according to the individual need and professionaljudgment of the person administering or supervising the administrationof the conjugate and/or other biologically active agent. In someembodiments, the antibody response of a subject administered thecompositions of the disclosure will be determined in the context ofevaluating effective dosages/immunization protocols. In most instancesit will be sufficient to assess the antibody titer in serum or plasmaobtained from the subject. Decisions as to whether to administer boosterinoculations and/or to change the amount of the composition administeredto the individual can be at least partially based on the antibody titerlevel. The antibody titer level can be based on, for example, animmunobinding assay which measures the concentration of antibodies inthe serum which bind to a specific antigen, for example, γDLPGA. Theability to neutralize in vitro and in vivo biological effects of the S.epidermidis can also be assessed to determine the effectiveness of thetreatment.

Dosage can be varied by the attending clinician to maintain a desiredconcentration at a target site (for example, the lungs or systemiccirculation). Higher or lower concentrations can be selected based onthe mode of delivery, for example, trans-epidermal, rectal, oral,pulmonary, or intranasal delivery versus intravenous or subcutaneousdelivery. Dosage can also be adjusted based on the release rate of theadministered formulation, for example, of an intrapulmonary spray versuspowder, sustained release oral versus injected particulate ortransdermal delivery formulations, and so forth. To achieve the sameserum concentration level, for example, slow-release particles with arelease rate of 5 nanomolar (under standard conditions) would beadministered at about twice the dosage of particles with a release rateof 10 nanomolar.

It is contemplated that delivery of the conjugates can be enhanced bymethods and agents that target selective transport mechanisms andpromote endo- or transcytocis of macromolecular drugs.

In this regard, the compositions and delivery methods of the disclosureoptionally incorporate a selective transport-enhancing agent thatfacilitates transport of one or more biologically active agents. Thesetransport-enhancing agents can be employed in a combinatorialformulation or coordinate administration protocol with one or more ofthe peptides, proteins, analogs and mimetics disclosed herein, tocoordinately enhance delivery of the biologically active agent(s) intotarget cells. Exemplary selective transport-enhancing agents for usewithin this aspect of the disclosure include, but are not limited to,glycosides, sugar-containing molecules, and binding agents such aslectin binding agents, which are known to interact specifically withepithelial transport barrier components (see, for example, Goldstein etal., Annu. Rev. Cell. Biol. 1:1-39, 1985). For example, specific“bioadhesive” ligands, including various plant and bacterial lectins,which bind to cell surface sugar moieties by receptor-mediatedinteractions can be employed as carriers or conjugated transportmediators for enhancing delivery of conjugates within the disclosure.Certain bioadhesive ligands for use within the disclosure will mediatetransmission of biological signals to epithelial target cells thattrigger selective uptake of the adhesive ligand by specialized cellulartransport processes (endocytosis or transcytosis). These transportmediators can therefore be employed as a “carrier system” to stimulateor direct selective uptake of the conjugate within the methods of thedisclosure. To utilize these transport-enhancing agents, general carrierformulation and/or conjugation methods known in the art are used tocomplex or otherwise coordinately administer a selective transportenhancer (for example, a receptor-specific ligand) and the conjugate totrigger or mediate enhanced endo- or transcytosis of the γPGA conjugate(such as the γDLPGA conjugate) into specific target cell(s), tissue(s)or compartment(s).

Lectins are plant proteins that bind to specific sugars found on thesurface of glycoproteins and glycolipids of eukaryotic cells.Concentrated solutions of lectins have a “mucotractive” effect, andvarious studies have demonstrated rapid receptor mediated endocytosis oflectins and lectin conjugates (for example, concanavalin A conjugatedwith colloidal gold particles) across mucosal surfaces. Additionalstudies have reported that the uptake mechanisms for lectins can beutilized for intestinal drug targeting in vivo. In certain of thesestudies, polystyrene nanoparticles (500 nm) were covalently coupled totomato lectin and reported yielded improved systemic uptake after oraladministration to rats. In addition to plant lectins, microbial adhesionand invasion factors provide a rich source of candidates for use asadhesive/selective transport carriers within the compositions andmethods of the disclosure (see, for example, Lehr, Crit. Rev. Therap.Drug Carrier Syst. 11:177-218, 1995 and Swann, Pharmaceutical Research15:826-32, 1998). Two components are necessary for bacterial adherenceprocesses, a bacterial “adhesin” (adherence or colonization factor) anda receptor on the host cell surface. Bacteria causing mucosal infectionsneed to penetrate the mucus layer before attaching themselves to theepithelial surface. This attachment is usually mediated by bacterialfimbriae or pilus structures, although other cell surface components canalso take part in the process. Adherent bacteria colonize mucosalepithelia by multiplication and initiation of a series of biochemicalreactions inside the target cell through signal transduction mechanisms(with or without the help of toxins).

Associated with these invasive mechanisms, a wide diversity ofbioadhesive proteins (for example, invasin, internalin) originallyproduced by various bacteria and viruses are known. These allow forextracellular attachment of such microorganisms with an impressiveselectivity for host species and even particular target tissues. Signalstransmitted by such receptor-ligand interactions trigger the transportof intact, living microorganisms into, and eventually through,epithelial cells by endo- and transcytotic processes. Such naturallyoccurring phenomena can be harnessed (for example, by complexing a γPGAconjugate with an adhesin according to the teachings herein for enhanceddelivery of the conjugates and/or other biologically active compounds.One advantage of this strategy is that the selective carrier partnersthus employed are substrate-specific, leaving the natural barrierfunction of epithelial tissues intact against other solutes (see, forexample, Lehr, Drug Absorption Enhancement, pp. 325-362, de Boer, Ed.,Harwood Academic Publishers, 1994).

Various bacterial and plant toxins that bind epithelial surfaces in aspecific, lectin-like manner are also useful within the methods andcompositions of the disclosure. For example, diphtheria toxin entershost cells rapidly by receptor mediated endocytosis. Likewise, the Bsubunit of the E. coli heat labile toxin binds to the brush border ofintestinal epithelial cells in a highly specific, lectin-like manner.Uptake of this toxin and transcytosis to the basolateral side of theenterocytes has been reported in vivo and in vitro. Other researcheshave expressed the transmembrane domain of diphtheria toxin in E. colias a maltose-binding fusion protein and coupled it chemically to high-Mwpoly-L-lysine. The resulting complex was successfully used to mediateinternalization of a reporter gene in vitro. In addition to theseexamples, Staphylococcus aureus produces a set of proteins (for example,staphylococcal enterotoxin A, staphylococcal enterotoxin B and toxicshock syndrome toxin 1) which act both as superantigens and toxins.Studies relating to these proteins have reported dose-dependent,facilitated transcytosis of staphylococcal enterotoxin B and toxic shocksyndrome toxin 1 in Caco-2 cells.

Various plant toxins, mostly ribosome-inactivating proteins, have beenidentified that bind to any mammalian cell surface expressing galactoseunits and are subsequently internalized by receptor mediatedendocytosis. Toxins such as nigrin b, sarcin, ricin and saporin,viscumin, and modeccin are highly toxic upon oral administration (thatis, they are rapidly internalized). Therefore, modified, less toxicsubunits of these compounds will be useful within the disclosure tofacilitate the uptake of the conjugates and other biologically activeagents, other bacterial products and analogs, variants, derivatives andmimetics thereof.

Viral hemagglutinins include another type of transport agent tofacilitate delivery of γPGA conjugates (such as the γDLPGA conjugate)and other biologically active agents within the methods and compositionsof the disclosure. The initial step in many viral infections is thebinding of surface proteins (hemagglutinins) to mucosal cells. Thesebinding proteins have been identified for most viruses, includingrotaviruses, Varicella zoster virus, semliki forest virus, adenoviruses,potato leafroll virus, and reovirus. These and other exemplary viralhemagglutinins can be employed in a combinatorial formulation (forexample, a mixture or conjugate formulation) or coordinateadministration protocol with, for example, one or more γPGA conjugates,PA immunogens, other bacterial products, or analogs, variants,derivatives and mimetics thereof. Alternatively, viral hemagglutininscan be employed in a combinatorial formulation or coordinateadministration protocol to directly enhance delivery of the conjugate orother biologically active agent within the disclosure.

A variety of endogenous, selective transport-mediating factors are alsoavailable for use with the disclosure. Exemplary among these areprotocytotic transport carriers within the folate carrier system, whichmediate transport of the vitamin folic acid into target cells viaspecific binding to the folate receptor (see, for example, Reddy et al.,Crit. Rev. Ther. Drug Car. Syst. 15:587-27, 1998). This receptor systemhas been used in drug-targeting approaches to cancer cells; but also inprotein delivery, gene delivery, and targeting of antisenseoligonucleotides to a variety of cell types. Folate-drug conjugates arewell suited for use within the methods and compositions of thedisclosure, because they allow penetration of target cells exclusivelyvia folate receptor-mediated endocytosis. When folic acid is covalentlylinked to a biologically active agent, folate receptor binding affinity(KD˜10-10M) is not significantly compromised, and endocytosis proceedsrelatively unhindered, promoting uptake of the attached active agent bythe folate receptor-expressing cell.

In addition to the folate receptor pathway, a variety of additionalmethods to stimulate transcytosis within the disclosure are directed tothe transferrin receptor pathway, and the riboflavin receptor pathway.In one aspect, conjugation of a γPGA conjugate (such as the γDLPGAconjugate) or other biologically active agent to riboflavin caneffectuate receptor mediated endocytosis uptake. Yet additionalembodiments of the disclosure utilize vitamin B12 (cobalamin) as aspecialized transporter (for example, conjugation partner) to facilitateentry of the conjugates and other biologically active agents into targetcells. Certain studies suggest that this particular system can beemployed for mucosal delivery into the intestine. Still otherembodiments of the disclosure utilize transferrin as a carrier orstimulant of receptor mediated endocytosis of mucosally deliveredbiologically active agents. Transferrin, an 80 kDa iron-transportingglycoprotein, is efficiently taken up into cells by receptor mediatedendocytosis. Transferrin receptors are found on the surface of mostproliferating cells, in elevated numbers on erythroblasts and on manykinds of tumors. Each of the foregoing agents that stimulatereceptor-mediated transport can be employed within the methods of thedisclosure as combinatorially formulated (for example, conjugated)and/or coordinately administered agents to enhance receptor-mediatedtransport of the conjugates and other biologically active agents,including, PA, carriers, linkers, and other bacterial toxins andanalogs, variants, derivatives and mimetics thereof.

Immunoglobulin transport mechanisms provide yet additional endogenouspathways and reagents for enhancing delivery of active agents within themethods and compositions of the disclosure. Receptor-mediatedtranscytosis of immunoglobulin G (IgG) across the neonatal smallintestine serves to convey passive immunity to many newborn mammals.Within the methods and compositions of the present disclosure, IgG andother immune system-related carriers (including polyclonal andmonoclonal antibodies and various fragments thereof) can be complexed orotherwise coordinately administered with the conjugates and otherbiologically active agents to provide for targeted delivery, typicallyby receptor-mediated transport. For example, the conjugate or otherbiologically active agent can be covalently linked to the IgG or otherimmunological active agent or, alternatively, formulated in liposomes orother carrier vehicle which is in turn modified (for example, coated orcovalently linked) to incorporate IgG or other immunological transportenhancer. In certain embodiments, polymeric IgA and/or IgM transportagents are employed, which bind to the polymeric immunoglobulinreceptors of target epithelial cells. Within these methods, expressionof polymeric immunoglobulin receptors can be enhanced by cytokines.

Within more detailed aspects of the disclosure, antibodies and otherimmunological transport agents can be themselves modified for enhanceddelivery of the conjugates or other biologically active agents. Forexample, antibodies can be more effectively administered within themethods and compositions of the disclosure by charge modifyingtechniques. In one such aspect, an antibody drug delivery strategyinvolving antibody cationization is utilized that facilitates bothtrans-endothelial migration and targeted cell endocytosis (see, forexample, Pardridge, et al., JPET 286:548-44, 1998). In one suchstrategy, the pI of the antibody is increased by converting surfacecarboxyl groups of the protein to extended primary amino groups. Thesecationized homologous proteins have no measurable tissue toxicity andhave minimal immunogenicity. In addition, monoclonal antibodies can becationized with retention of affinity for the target protein.

Additional selective transport-enhancing agents for use within thedisclosure include whole bacteria and viruses, including geneticallyengineered bacteria and viruses, as well as components of such bacteriaand viruses. This aspect of the disclosure includes the use of bacterialghosts and subunit constructs, for example, as described by Huter etal., J. Control. Rel. 61:51-63, 1999. Bacterial ghosts are non-denaturedbacterial cell envelopes, for example as produced by the controlledexpression of the plasmid-encoded lysis gene E of bacteriophage PhiX174in gram-negative bacteria. Protein E-specific lysis does not cause anyphysical or chemical denaturation to bacterial surface structures, andbacterial ghosts are therefore useful in development of inactivatedwhole-cell vaccines. Ghosts produced from Actinobacilluspleuropneumoniae, Pasteurella haemolytica and Salmonella sp. have provedsuccessful in vaccination studies. Recombinant bacterial ghosts can becreated by the expression of foreign genes fused to a membrane-targetingsequence, and thus can carry foreign therapeutic peptides and proteinsanchored in their envelope. The fact that bacterial ghosts preserve anative cell wall, including bioadhesive structures like fimbriae oftheir living counterparts, makes them suitable for the attachment tospecific target tissues such as mucosal surfaces. Bacterial ghosts havebeen shown to be readily taken up by macrophages, thus adhesion ofghosts to specific tissues can be followed by uptake through phagocytes.

In view of the foregoing, a wide variety of ligands involved inreceptor-mediated transport mechanisms are known in the art and can bevariously employed within the methods and compositions of the disclosure(for example, as conjugate partners or coordinately administereddelivery enhancers) to enhance delivery or receptor-mediated transportof γPGA conjugates and other biologically active agents, includingbacterial products. Generally, these ligands include hormones and growthfactors, bacterial adhesins and toxins, lectins, metal ions and theircarriers, vitamins, immunoglobulins, whole viruses and bacteria orselected components thereof. Exemplary ligands among these classesinclude, for example, calcitonin, prolactin, epidermal growth factor,glucagon, growth hormone, estrogen, lutenizing hormone, platelet derivedgrowth factor, thyroid stimulating hormone, thyroid hormone, choleratoxin, diphtheria toxin, E. coli heat labile toxin, Staphylococcalenterotoxins A and B, ricin, saporin, modeccin, nigrin, sarcin,concanavalin A, transcobalantin, catecholamines, transferrin, folate,riboflavin, vitamin B1, low density lipoprotein, maternal IgO, polymericIgA, adenovirus, vesicular stomatitis virus, Rous sarcoma virus, V.cholerae, Kiebsiella strains, Serratia strains, parainfluenza virus,respiratory syncytial virus, Varicella zoster, and Enterobacter strains(see, for example, Swann, Pharmaceutical Research 15:826-32, 1998).

In certain additional embodiments of the disclosure, membrane-permeablepeptides (for example, “arginine rich peptides”) can be employed tofacilitate delivery of γDLPGA conjugates or other biologically activeagents of the disclosure. (See WO 2005/000884 A1, published Jan. 6,2005). While the mechanism of action of these peptides remains to befully elucidated, they provide useful delivery enhancing adjuncts foruse within the compositions and methods herein.

The methods of using γPGA conjugates and the related compositions andmethods of the disclosure, are useful in increasing resistance to,preventing, ameliorating, and/or treating infection and disease causedby Staphylococcus in animal hosts, and other, in vitro applications. Forexample, the methods and compositions are useful in increasingresistance to, preventing, ameliorating, and/or treating infection anddisease caused by S. epidermidis infection in animals and humans. Theseimmunogenic compositions can be used for active immunization forprevention of S. epidermidis infection, and for preparation of immuneantibodies. In one embodiment, the therapeutic compositions and methodsare designed to confer specific immunity against infection with S.epidermidis, and to induce antibodies specific to S. epidermidis γDLPGA.The therapeutic compositions are composed of non-toxic components,suitable for infants, children of all ages, and adults.

The methods of the disclosure are broadly effective for treatment(including prevention) of an S. epidermidis infection or other relatedstaphylococci infections. In selected embodiments, one or more symptomsor associated effects of exposure to and/or infection with S.epidermidis can be prevented or otherwise treated by administration to amammalian subject at risk of S. epidermidis infection, or presentingwith one or more Staphylococcus symptom(s), of an effective amount of animmunogenic γPGA composition (such as the γDLPGA composition) of thedisclosure. Therapeutic compositions and methods of the disclosure forprevention or treatment of toxic or lethal effects of bacterialinfection are applicable to a wide spectrum of infectious agents. Anysignificant reduction or preventive effect of the composition withrespect to the foregoing disease condition(s) or symptom(s) administeredconstitutes a desirable, effective property of the subjectcomposition/method of the disclosure.

The compositions and methods of the disclosure are particularly usefulfor treatment and prevention of infection of exposure to S. epidermidisand/or other disease- or illness-causing staphylococci. Additionalembodiments of the disclosure are directed to diagnostic compositionsand methods to identify individuals at risk for exposure, infection, orlong term deleterious effects of exposure to pathogenic bacteria, forexample S. epidermidis. In additional aspects of the disclosure, themethods and compositions disclosed herein are useful for identificationof environmental agents, including S. epidermidis and otherstaphylococci expressing a γPGA. Methods and compositions of thedisclosure are employed to detect, and alternatively to treat and/orameliorate, such ubiquitous environmental exposures and associatedsymptoms. For example, antibodies of the disclosure provide forscreening for γDLPGA in mammalian subjects at risk of contact/infectionwith S. epidermidis.

In related embodiments, the disclosure provides compositions, includingbut not limited to, mammalian serum, plasma, and immunoglobulinfractions, which contain antibodies that are immunoreactive with aγDLPGA of S. epidermidis or another Staphylococcus species or strain.These antibodies and antibody compositions can be useful to treat(including prevent), and/or otherwise ameliorate infection and diseasecaused by the microorganism. The disclosure also provides suchantibodies in isolated form. In exemplary embodiments, high titeranti-γDLPGA sera, antibodies isolated therefrom, or monoclonalantibodies, can be used for therapeutic treatment for patients withinfection by S. epidermidis or another Staphylococcus species or strain.Antibodies elicited by the agents of this disclosure can be used for thetreatment of established S. epidermidis or other Staphylococcusinfections, and can also be useful in providing passive protection to anindividual exposed to S. epidermidis or another Staphylococcus, such asa coagulase-negative Staphylococcus.

The instant disclosure also includes kits, packages and multi-containerunits containing the herein described pharmaceutical compositions,active ingredients, and/or means for administering the same for use inthe prevention and treatment of S. epidermidis and other Staphylococcusdiseases and other conditions in mammalian subjects. Kits for diagnosticuse are also provided. These kits may include a container or formulationthat contains one or more of the γPGA conjugates and/or other activeagent described herein to detect S. epidermidis infection. For example,the composition is formulated in a pharmaceutical preparation fordelivery to a subject. The γPGA conjugate (such as the γDLPGA conjugate)and/or other biologically active agent is/are optionally contained in abulk dispensing container or unit or multi-unit dosage form. Optionaldispensing methods may be provided, for example a pulmonary orintranasal spray applicator. Packaging materials optionally include alabel or instruction indicating for what treatment purposes (forexample, S. epidermidis) and/or in what manner the pharmaceutical agentpackaged therewith can be used.

The subject matter of the present disclosure is further illustrated bythe following non-limiting Examples.

EXAMPLE 1 Materials and Methods

Bacterial Strains, Growth Conditions, and Basic Molecular BiologyMethods

The clinical isolate S. epidermidis 1457 (Mack, D., et al. Infect.Immun. 62: 3244-3253, 1994) was used in this study. Bacteria were grownin tryptic soy broth (TSB) unless otherwise noted. Antibiotics were usedat the following concentrations: chloramphenicol, 10 μg/ml;spectinomycin, 100 μg/ml; and ampicillin, 100 μg/ml. Cultures wereincubated at 37° C. with shaking at 200 rpm. DNA manipulation, isolationof plasmid DNA, and transformation of Escherichia coli were performedusing standard procedures. Staphylococcal plasmid DNA was prepared withthe Qiagen Plasmid Midi Kit as described (Vuong, C., Gerke, C.,Somerville, G. A., Fischer, E. R., and Otto, M. J. Infect Dis. 188:706-718, 2003). S. epidermidis was transformed by electroporation asdescribed (Augustin, J., et al. Eur. J. Biochem. 204: 1149-1154, 1992).Polymerase chain reactions (PCRs) were performed with Ready-To-Go PCRBeads (Amersham Biosciences) as recommended by the manufacturer. DNA wassequenced using Big Dye Terminator cycle sequencing (version 3.0) on anABI3700 sequencer (Applied Biosystems). Nucleotide sequences wereanalyzed using the program Vector NTI Suite (InforMax). Primers for DNAamplifications by PCR were purchased from Sigma Genosys. The followingoligonucleotides were used in this study for TaqMan analysis of capexpression: capF (SEQ ID NO: 1), capProbe (SEQ ID NO: 2), and capR (SEQID NO: 3). For allelic replacement of the cap locus, primers CapEco (SEQID NO: 4), CapBam (SEQ ID NO: 5), CapSal (SEQ ID NO: 6), and CapHind(SEQ ID NO: 7) were employed. In the construction of complementationvectors studies, oligoprimers capBam2 (SEQ ID NO: 8) and capXba (SEQ IDNO: 9) were utilized. To confirm the lack of cap expression in the capmututant strain by real-time PCR, the following primers were used: CAP1(SEQ ID NO: 10), CAP2 (SEQ ID NO: 11), C2P1 (SEQ ID NO: 12) and C2P5(SEQ ID NO: 13). Amplification of the capB probe for the Southern blotassays utilized the following primers: CapSB2 (SEQ ID NO: 14), CapSB3(SEQ ID NO: 15), CapSB-D3 (SEQ ID NO: 16), CapSB-D4 (SEQ ID NO: 17),CapSB-A1 (SEQ ID NO: 18), CapSB-A2 (SEQ ID NO: 19), CapSB-C1 (SEQ ID NO:20), and CapSB-D4 (SEQ ID NO: 21). The 74 strains used forepidemiological studies were obtained from N. El Solh (Institut Pasteur,Paris, France) and are predominantly nonclonal (Galdbart, J. O., Morvan,A., Desplaces, N., and El Solh, N. J. Clin. Microbiol. 37: 1306-1312,1999).

Real-Time PCR.

RNA isolation was performed using a FastPrep BLUE Kit (Q-BioGene Inc.).Oligonucleotide primers and probes were designed using Primer Express2.0 software (Applied Biosystems). The probe used for analysis of capexpression was located within the capB gene. TaqMan analysis wasperformed in a 384-well MicroAmp Optical using a 7900 Sequence Detector(Applied Biosystems). Standard curves were determined with purifiedchromosomal template DNA at concentrations ranging from 0.001 ng/ml to10 ng/ml. Assays were performed in triplicate using cDNA samples, and16S rRNA as control, with a standard cycle protocol.

Southern Blot Analysis.

Equal amounts of EcoRV-digested genomic DNA were separated by gelelectrophoresis on a 0.7% agarose gel and visualized by ethidium bromidestaining. DNA was transferred onto a nylon membrane (GE OsmonicsLabstore) and probed with digoxigenin-labeled PCR product amplified fromthe capB or capD genes of S. epidermidis 1457 or with a cocktail ofprobes amplified from the capA, capB, capC, and capD genes.Prehybridization, hybridization, posthybridization, and immunologicdetection were performed as described in the technical updateaccompanying the nonradioactive DNA Labeling and Detection Kit (RocheApplied Science). For immunologic detection, the membrane was incubatedwith a 1:5,000 dilution of sheep anti-digoxigenin Fab fragmentsconjugated to alkaline phosphatase. Probe-target hybrids were detectedusing the chromogenic substrate nitrobluetetrazolium/5-bromo-4-chloro-3-indolyl phosphate.

Immuno-Dot Blot Assay.

Surface-attached γDLPGA was released from the cell surface by boilingbacteria for 30 minutes at 100° C. or by autoclaving. γDLPGA was thenpurified by acid precipitation as described in Hariby E. E., and Rydon,H. N. Biochemistry. 40: 297-307, 1946. Aliquots (3 μl) of the sampleswere spotted on a nitrocellulose membrane, air-dried, and γDLPGA wasdetected with anti-γDLPGA antiserum using a scanner and Total LabVersion 2003 software (Nonlinear USA). The assay was calibrated byserial dilution of the most intensive sample. The value detected in thewild-type strain was set to 100% and production values in the otherstrains were expressed relative to that value. Anti-γDLPGA antiserum(kindly provided by R. Schneerson, National Institute of Child Health &Human Development, NIH, Bethesda, Md., USA) was developed against PGAfrom Bacillus pumilus. For Staphylococcus strains other than S.epidermidis, a strain with a signal higher than that of the backgroundof the S. epidermidis Δcap mutant was considered a PGA producer.

Construction of an Isogenic Cap Deletion Mutant and Cap-ComplementingVector.

To delete capBCAD in S. epidermidis 1457, PCR-amplified regions flankingthe cap locus and a spectinomycin resistance cassette were cloned intoplasmid pBT2 (Bruckner, R. FEMS Microbiol. Lett. 151: 1-8, 1997),yielding plasmid pBTΔcap, which was used for allelic replacement asdescribed (Vuong, C., Gotz, F., and Otto, M. Infect. Immun. 68:1048-1053, 2000). The proper integration of the resistance gene markerspc was verified by direct sequencing of the genomic DNA at the bordersof the PCR-derived regions. Lack of cap transcript in the cap mutantstrain was verified by real-time PCR. S. epidermidis 1457 in whichcapBCAD was deleted was named S. epidermidis Δcap. To complement forcapBCAD in S. epidermidis Δcap, capBCAD genes were cloned into plasmidpRB474 (Brückner, R. FEMS Microbiol. Lett. 151: 1-8, 1997). Theresulting plasmid was named pRBcapBCAD.

Purification of γDLPGA and Detection of D- and L-Glutamic Acid.

Cultures were grown in TSB medium supplemented with 1 M NaCl to induceγDLPGA production. γDLPGA was first purified as described above. Then,γDLPGA samples were further purified by ion exchange chromatographyusing a RESOURCE Q 6 ml column (Amersham Biosciences) on an AKTAPurifier 10 (Amersham Biosciences) and a gradient from 0.2% acetic acidto 0.2% acetic acid/1 M NaCl in 20 column volumes at a flow rate of 5ml/min. Fractions with positive reaction in an immuno-dot blot werecombined, dialyzed against water, lyophilized, resuspended in 6 M HCl,and hydrolyzed at 110° C. for 24 hours. Samples were lyophilized againand dissolved in 200 μl of water. Ten microliters of the samples werethen injected onto a Chirobiotic T column (Astec) using 0.1%triethylammonium acetate (pH 4.0) in 80% ethanol as elution buffer at aflow rate of 0.4 ml/min. Chromatography was performed using an Agilent1100 series HPLC connected to a VL Trap mass spectrometer. The extractedion chromatograms at 146 Da, the mass of glutamic acid, were used todetermine the amounts of D- and L-glutamic acid by peak integration incomparison to pure D- and L-glutamic acid.

Isolation of Human Polymorphonuclear Leukocytes and PhagocytosisExperiments.

Human polymorphonuclear leukocytes (PMNs) were isolated from heparinizedvenous blood of healthy individuals with a standard method (Voyich, J.M., et al. Proc. Natl. Acad. Sci. U.S.A. 100: 1996-2001, 2003). Allstudies were performed in accordance with a protocol approved by theInstitutional Review Board for Human Subjects of NIAID. Cellpreparations contained approximately 99% PMNs and all reagents usedcontained <25.0 pg/ml endotoxin. Phagocytosis of S. epidermidis by humanPMNs was analyzed by flow cytometry with a previously described method(Voyich, J. M., et al. Proc. Natl. Acad. Sci. U.S.A. 100: 1996-2001,2003). Briefly, bacteria were cultured to stationary growth phase,washed in PBS, and labeled with fluorescein-5-isothiocyanate for 15minutes. PMNs (10⁶/100 μl) and bacteria (2×10⁷/100 μl) were combined inwells of serum-coated 96-Well round-bottom microtiter plates. Plateswere incubated for 30 minutes at 37° C. and the degree of phagocytosiswas determined by flow cytometry.

Peptide Bacterial Killing Assays.

S. epidermidis cultures were harvested, washed with PBS buffer, andresuspended in 10 mM sodium phosphate buffer (pH 7.0). Bacterial killingassays were performed using a final concentration of approximately 10⁵S. epidermidis cells in each sample. Antimicrobial peptides weredissolved in the following solutions: human β-defensin 3, 10 mM aceticacid, and LL-37, 10% acetonitrile with 0.1% trifluoroacetic acid. Thebacteria were exposed to a range of antimicrobial peptide concentrations(0, 5, 10, 20, 30, and 40 μg/ml). An equal volume of the respectivepeptide dilution buffer was applied to control samples. Samples wereincubated at 37° C. for 2 hours and appropriate dilution series of thesamples were plated on TSB agar. Survivor S. epidermidis cells wereenumerated after 24 hours of incubation at 37° C. The percentage ofkilled S. epidermidis was calculated using the formula (1−[CFU_(peptide)/CFU_(control)])×100.

Scanning Immunoelectron Microscopy.

Fifty-microliter aliquots of S. epidermidis cultures were washed withPBS buffer. Cells were resuspended in 200 μl of anti-γDLPGA antiserumand incubated at 37° C. with agitation at 400 rpm for 12 hours. Sampleswere washed with PBS and pellets were subsequently incubated with goatanti-rabbit IgG conjugated with 20 nm of gold (BB International) at 37°C. with agitation at 400 rpm for 2 hours. Following antibody labeling,the cell suspensions were attached to coverslips, fixed with 2.5%glutaraldehyde in 0.1 M sodium cacodylate, and post-fixed with 1% osmiumtetroxide in 0.1 M sodium cacodylate. Samples were washed with distilledwater, dehydrated in a graded ethanol series, critical-point dried underCO₂ with a Bal-Tec model cpd 030 drier (Balzers), mounted on aluminumstuds, and sputter-coated with 100 angstroms of chromium in a modelIBS/TM200S ion beam sputterer (South Bay Technologies) prior to viewingat 10 kV on a Hitachi S-4500 field emission scanning electron microscope(Hitachi) in backscatter imaging mode.

Murine Model of Device-Related Infection.

Female Balb/c mice were used in a model of subcutaneous implanteddevice-related infection as described (Kadurugamuwa, J. L., et al.Infect. Immun. 71:882-890, 2003). Two catheter pieces of 1-cm lengthwere placed under the skin of the dorsum of each animal. CFUs oncatheters were counted before insertion and were in the range of 2×10⁵on all implanted catheters. CFU on excised catheters and surroundingtissues were counted after 1 week of infection. All studies wereperformed in accordance with a protocol approved by the Animal Care andUse Committee of Rocky Mountain Laboratories, NIAID.

Statistics and DNA Sequence Analysis.

Statistical analysis was performed using GraphPad Prism version 4.0. DNAsequences were compared using Clustal W software.

EXAMPLE 2 Molecular Genetic Comparison of Bacteria with Genes Encoding aPutative PGA Synthesis Machinery

This example demonstrates that the S. epidermidis genome contains thegenes that code for PGA synthesis.

Only recently, it was discovered that the biofilm exopolysaccharidepolysaccharide intercellular adhesin (PIA) protects S. epidermidis frommajor mechanisms of innate host defense (Vuong, C., et al. Cell.Microbiol. 6: 269-275, 2004). Howevd, PIA is restricted to asubpopulation of S. epidermidis, and therefore, a ubiquitous principleprotecting S. epidermidis from innate host defense has remained elusive.Thus, the recently published S. epidermidis genome (Zhang, Y. Q., et al.Mol. Microbiol. 49:1577-1593, 2003) was searched for gene locipotentially involved in such protection. Phylogenetic trees wereconstructed based on sequence comparisons of the capB (amide ligase),capC (unknown function), and capD (depolymerase) genes. CapA is aputative PGA exporter. A comparison of capA genes (putative PGAexporters) was excluded because capA homologs were not found in all theorganisms and comparison of transporters is normally less indicative ofphylogenetic relations. The resulting phylogenetic trees arepresented-in FIG. 1A. Of the microorganisms shown, production of PGA hasbeen demonstrated previously only in B. anthracis and B. subtilis.

As illustrated in FIG. 1A, in contrast to its relative S. aureus, S.epidermidis has the cap locus that codes for production of the anionicexopolymer PGA. Further, the S. epidermidis cap genes show highsimilarity to those of B. anthracis and B. subtilis. In addition, asdemonstrated in FIG. 1B, in contrast to B. subtilis and several humanpathogens that have parts of the cap genes, the genetic organization ofthe cap locus of B. anthracis is well conserved in S. epidermidis. Ofnote, the B. anthracis cap gene cluster is located on a plasmid andflanked by IS231 insertion sequences. All other genes are located in thebacterial chromosomes.

EXAMPLE 3 PGA Production in S. epidermidis

This example demonstrates that the S. epidermidis cap gene locus drivesproduction of surface-attached PGA.

In FIGS. 2A-2C, Δcap represents the isogenic cap deletion strain.Further, capBCAD is the complemented strain S. epidermidis Δcap(pRBcapBCAD).

To analyze the role of the cap genes in S. epidermidis, a deletionmutant (S. epidermidis Δcap) was constructed, in which the entire caplocus was replaced by a spectinomycin resistance cassette. To complementthe mutant, the cap operon was cloned with its natural promoter in aplasmid and transformed the mutant with that plasmid (pRBcapBCAD). PGAproduction was determined in the mutant, wild-type, and complementedstrains. Real-time PCR data indicated that the cap genes in S.epidermidis are expressed. Accordingly, relative expression of PGA wasdetermined by immuno-dot blot analysis. PGA was extracted from bacterialcell surfaces as described in Example 1: Methods. A calibration curvewas obtained by dilution of the most intensive sample obtained from thePGA-overexpressing complemented strain S. epidermidis Δcap (pRBcapBCAD).Results are the mean±SEM of 4 experiments for the samples and themean±SEM of 4 different serial dilutions for the calibration curve. Arepresentative blot is shown at the top of FIG. 2A. As illustrated inFIG. 2A, immunodetection of PGA in cell surface extracts of thewild-type and complemented strains demonstrated that PGA is synthesizedby S. epidermidis and attached to the bacterial cell surface. Further,as shown in FIG. 2A, the PGA production level in the complemented strainwas 147% of that of the wild-type strain. There was no detectable signalin the cap deletion strain or in any samples obtained from culturefiltrates (FIG. 2A).

FIG. 2B includes scanning electron microscopy images of mutant,wild-type, and complemented strains cell surface extracts labeled withimmunogold confirming that PGA is located on the S. epidermidis cellsurface (FIG. 2B). PGA was detected with anti-PGA antiserum.

Next, to verify that the immunoreactive material constituted γDLPGA theimmunoreactive material was purified and quantitative and qualitativeanalyses were performed. In particular, D-glutamic (D-Glu) andL-glutamic (L-Glu) acid levels in S. epidermidis PGA were analyzed bystereoselective chromatography and liquid chromatographic-massspectrometric detection. To determine D- and L-glutamic acid amounts,the L-glutamic acid background detected in the cap mutant strain (Δcap)was subtracted from PGA expression strains.

In contrast to B. anthracis PGA, which is entirely composed ofD-glutamic acid (Ashiuchi, M., and Misono, H. Appl. Microbiol.Biotechnol. 59:9-14, 2002), S. epidermidis PGA consisted of about equalamounts of D- and L-glutamic acid (FIG. 2C). Notably, γDLPGA productionin S. epidermidis was far less than that reported for B. anthracis(1.2×10⁻⁶ gil for S. epidermidis versus 5-10 g/l for B. anthracis(Hariby E. E., and Rydon, H. N. Biochemistry. 40: 297-307, 1946). Takentogether, the data demonstrate that the cap locus in S. epidermidisdrives production of a surface-attached form of γDLPGA.

EXAMPLE 4 γPGA Production in S. Epidermidis Strains

This example demonstrates that the cap gene locus and PGA production areubiquitous among S. epidermidis strains.

γPGA expression in S. epidermidis strains of clinical and commensalorigin under low and high salt conditions was determined by immuno-dotblot analysis. First, cells were grown for 24 hours at 37° C. withshaking at 200 rpm. γDLPGA was then purified as described in Example 1,Methods. Results of the present studies are shown in FIG. 3. Horizontalbars in FIG. 3 show the group mean. The membrane background wassubtracted from each sample. The studies, including purification anddetection, were repeated twice with very similar results.

Some virulence factors in staphylococci, such as PIA, are mostlyrestricted to invasive strains (Otto, M. Front. Biosci. 9: 841-863,2004; Galdbart, J. O., Allignet, J. Tung, H. S., Ryden, C., and El Solh,N. J. Infect. Dis. 182: 351-355, 2000). In contrast, all 74 S.epidermidis strains of clinical and commensal origin that wereinvestigated in the present study had the cap gene locus as shown byanalytical PCR and were positive for γDLPGA by immuno-dot blot analysis(FIG. 3), indicating that γDLPGA production is ubiquitous in S.epidermidis. There was no significant difference in γDLPGA productionbetween commensal and clinical strains (FIG. 3). Therefore, it isbelieved that γDLPGA is important for the survival of S. epidermidis asa skin commensal organism and during infection.

EXAMPLE 5 Role of γDLPGA in Osmoprotection and Inducibility of CapExpression by NaCl

This example demonstrates that γDLPGA contributes to the ability of S.epidermidis to exist in high salt concentrations.

It was determined if γDLPGA impacts survival of S. epidermidis underconditions found in its natural habitat, surface of the human skin. Theenvironment on human skin is characterized by high and varying saltconcentration. S. epidermidis can withstand very high saltconcentrations of up to approximately 2 M NaCl, but the reasons for thisextraordinary resistance are not completely clear (Otto, M. Front.Biosci. 9: 841-863, 2004). Thus, growth (FIG. 4A; OD₆₀₀) and viability(FIG. 4B; CFU) of wild-type and cap mutant strains in Luria-Bertanimedium supplemented with 2 M NaCl were evaluated. Bacteria wereinoculated from an overnight preculture (1:1,000) and grown in flasks at37° C. with shaking at 200 rpm. Values presented are the mean±SEM of 3experiments. *P<0.05; **P<0.01; ^(#)P<0.001 (wild-type versus mutantstrain).

As shown in FIGS. 4A and 4B, respectively, growth and viability of thecap mutant strain were significantly impaired at high concentrations ofNaCl. In contrast, growth at physiological salt concentration wassimilar for the wild-type and mutant strains.

In addition, NaCl inducibility of cap expression was analyzed byquantitative real-time PCR. Bacteria were grown as described for FIG. 4Awith the indicated concentrations of NaCl. Cells were harvested after 6hours of growth, RNA was isolated, and real-time PCR was performed usinga capB probe. Values are the mean±SEM of 3 experiments. Results arepresented in FIG. 4C. As shown in FIG. 4C, the relative cap expressionincreased as the NaCl concentration increased. Similar findings werefound with immuno-dot blots. Thus, the present data coupled withfindings shown in FIG. 3 (γDLPGA production was greater at high NaClconcentration) suggest that γDLPGA contributes to survival of S.epidermidis on human skin.

EXAMPLE 6 Role of γDLPGA in Immune Evasion and Virulence of S.epidermidis

This example demonstrates that S. epidermidis γDLPGA provides protectionfrom key components of innate host defense.

γDLPGA's contribution to S. epidermidis virulence was investigated.Unlike its more aggressive relative S. aureus, S. epidermidis does nothave a large arsenal of virulence factors (Vuong, C., and Otto, M.Microbes Infect. 4:481-489, 2002). Rather, it causes relatively silent,chronic infections during which resistance against attacks by the innateimmune system is of special importance to bacterial survival (Vuong, C.,and Otto, M. Microbes Infect. 4:481-489, 2002). Therefore, whether capexpression in S. epidermidis affects resistance to key components ofinnate host defense against bacterial infections, namely antibacterialpeptides and neutrophil phagocytosis was investigated.

Resistance to cationic antimicrobial peptides was determined byincubating washed S. epidermidis cells (approximately 10⁵) with LL-37 orhuman β-defensin 3 in various concentrations of antimicrobial peptidesfor 2 hours at 37° C. Thereafter, S. epidermidis survivor cells werecounted by plating. Results are shown as dose-response curves. The logLD₅₀ values for all strain/peptide combinations are given in the key.Statistical analyses are for each peptide concentration. Values ofsignificance were calculated against the wild-type (for Δcap) and Δcap(for capBCAD) strains.

In addition, phagocytosis by human neutrophils was determined after 30minutes of incubation with S. epidermidis at a ratio of 20 bacteria perPMN.

As demonstrated in FIGS. 5A and 5B, the cap mutant strain hadsignificantly reduced resistance to 2 representative antibacterialpeptides from human skin and neutrophil specific granules, LL-37 (FIG.5A) and human β-defensin 3 (FIG. 5B). Further, as shown in FIG. 5C, thecap mutant strain had significantly increased susceptibility tophagocytosis by human neutrophils. For example, the phagocytosis ratewas 42% higher with the mutant strain compared to the wild-type strain.This is a relatively large difference compared with what is observedwith other single pathogen factors. These findings indicate that γDLPGAplays a critical role in protecting S. epidermidis from the microcidaleffects of innate host defense components.

EXAMPLE 7 Role of γDLPGA in Immune Evasion and Virulence of S.epidermidis

This example demonstrates that γDLPGA is indispensable for S.epidermidis persistence on in-dwelling medical devices in an animalinfection model.

The role of γDLPGA in protection from innate host defense componentssuggested that γDLPGA facilitates pathogen survival during S.epidermidis infection. Thus, to determine the role of γDLPGA in S.epidermidis persistence, the persistence of wild-type and isogenic capmutant strains in a mouse model of subcutaneous catheter infection wasevaluated. Catheter pieces with equal amounts of adhered S. epidermidiscells (2×10⁵) were placed under the dorsum of the animals. CFU onimplanted devices 1 week after infection were counted. Results areillustrated in FIG. 5D. The horizontal bar shows the group mean.*P<0.05; ***P<0.01; ***P<0.001.

Importantly, biofilm formation on plastic material and intercellularaggregation in vitro did not differ between wild-type and cap mutantstrains, indicating that colonization and persistence in the animalmodel were not due to differences in the physicochemical interactionwith the catheter material. As illustrated in FIG. 5D, most mice (5 of8) infected with the wild-type strain had significant numbers ofbacteria (approximately 3×10⁴-6×10⁴ CFU) on implanted catheters after 1week of infection, whereas all 7 mice infected with the cap mutantstrain had completely cleared the infection. This pronounced differenceindicates that γDLPGA is a key factor for the success of S. epidermidisin device-associated infection, which represents a predominant type ofdisease caused by this organism. Hence biofilm formation can beinhibited by decreasing expression of γDLPGA from S. epidermidis, bypromoting a specific immune response against it, or by otherwisedisrupting the formation of γDLPGA by the S. epidermidis.

EXAMPLE 8 Role of γDLPGA in Immune Evasion and Virulence of S.epidermidis

This example demonstrates that a group of coagulase-negativestaphylococci related to S. epidermidis also produces γDLPGA.

It is known from publicly available genome sequencing data that the caplocus is absent from S. aureus. To investigate whether otherstaphylococcal species have the genetic information for γDLPGAproduction, a series of staphylococcal strains were evaluated for thepresence of the cap genes by DNA-DNA hybridization using capB and capDprobes and a cocktail of probes from all 4 cap genes. Of 22 strains,representing 16 different species and subspecies, genomic DNA from 11strains hybridized with probes (Table 1). Except for S. saprophyticusstrains, all strains with a signal in the Southern blot also producedsurface-attached γDLPGA, which was demonstrated using anti-PGA antisera(Table 1). Although there are some intraspecies differences, it isremarkable that all phylogenetically related members of the S.epidermidis group (S. epidermidis, S. capitis, S. warneri, S.saccharolyticus, S. caprae, S. hominis, and S. haemolyticus) (Saruta,K., et al. FEMS Microbiol. Lett. 146: 271-278, 1997) have the ability toproduce γDLPGA, whereas it is far less distributed among other species(Table 1). Therefore, biofilm formation can be inhibited by disruptingγDLPGA in a variety of staphylococci that express γDLPGA. Moreover,Staphylococci can be categorized into those that secrete γDLPGA andthose that do not. Secretion positive staphylococci are likely to be inthe S. epidermidis group, although there are several exceptions. Hencethe antibodies disclosed herein that specifically recognize the γDLPGAand bind to it can be used for diagnostic purposes (for example if theyare labeled for detection), for example in the taxonomic classificationof such bacteria. Binding of the specific binding agents also indicatesthat the organisms are candidates for treatment with the methods andcompositions disclosed herein.

TABLE 1 PGA production in staphylococci Presence of capB PGA and capDStrain ATCC no. production^(A) genes^(B) S. epidermidis group S. capitissubsp. capitis ATCC 27840 + + S. capitis subsp. ureolyticus ATCC49324 + + S. caprae ATCC 51548 + + S. haemolyticus ATCC 29970 + + S.warneri ATCC 17917 + + S. warneri ATCC 49518 − − S. saccharolyticus ATCC14953 + + S. hominis subsp. hominis ATCC 25615 + + S. hominis subsp.hominis ATCC 27844 − − Other staphylococci S. schleiferi subsp.schleiferi ATCC 43808 − − S. pulveri ATCC 51698 − − S. simulans ATCC31432 − − S. simulans ATCC 700576 + + S. simulans ATCC 27848 − − S.xylosus ATCC 49148 − − S. xylosus ATCC 29966 − − S. saphrophyticus ATCC35552 − + S. saphrophyticus ATCC 15305 − + S. cohnii subsp. cohnii ATCC29972 − − S. cohnii subsp. urealyticum ATCC 49328 − − S. lugdunensisATCC 43809 + + S. intermedius ATCC 49052 − − S. aureus All strains withND − known genome sequence ^(A)By immuno-dot blot analysis. ^(B)BySouthern blot analysis. ND, not determined.

EXAMPLE 9 Constructing Immune Conjugates and Linking the Conjugates to aCarrier

Based on the teachings herein, one can construct immune conjugatesincluding Staphylococcus capsular γPGA polypeptides (such as γPGApolypeptides). It is contemplated that these immune conjugates can beprepared by isolating and purifying γPGA polypeptides by methods wellknown in the art. For example, γPGA polypeptides may be isolated andpurified by salt fractionation, phenol extraction, precipitation withorganic solvents (for example, hexadecyltrimethylammonium bromide(cetavlon) or ethanol), affinity chromatography, ion-exchangechromatography, hydrophobic chromatography, high performance liquidchromatography, gel filtration, isoelectric focusing, and liketechniques. Further, it is contemplated that Staphylococcus γPGApolypeptide conjugates may include carriers to enhance the immunogenicresponse. For example, a carrier can be linked to a γDLPGA polypeptideas described in Section III.A.

EXAMPLE 10 Method of Treating an Infection Caused by a StaphylococcusOrganism that Expresses Cap Genes

According to the teachings herein, one can treat an infection caused bya Staphylococcus organism that expresses cap geries. In an example, asubject who is at risk or has been diagonosed with the infection by theStaphylococcus organism which expresses γPGA, such as γDLPGA, forexample from the cap genes is identified. For example, a subject whichis to receive or has received an in-dwelling device such as a catheter,artificial joint, pacemaker, and like device is selected for treatmentprior to or following laboratory detection of the Staphylococcusorganism. It is contemplated that the Staphylococcus organism caninclude S. capitis, S. warneri, S. saccharolyticus, S. caprae, S.hominis, S. haemolyticus, S. lugdunensis, S. simulans, or S. epidermidisas well as a combination thereof.

Following subject selection, the expression of γPGA (such as γDLPGA)polypeptide by the organism can be altered. For example, the expressionof γPGA can be altered by promoting an immune response against the γPGA.The promoting of the immune response against γPGA can includeadministering an effective amount of a conjugate. The conjugate can beprepared as described above in Section III.A. In an additional example,promoting the immune response against the γPGA can include interferingwith expression of the γPGA such as by inhibiting expression of theγDLPGA by the cap genes. In a further example, promoting the immuneresponse against the γPGA entails administering an effective amount anantiserum. The antiserum includes an effective amount of anti-γPGAantibodies effective to enhance an immune response against the organism.The anti-γPGA antibodies can be prepared by skills well known in the artas well as by methods described previously in Section III.B. In anotherexample, the expression of γPGA is inhibited and thereby formation of abiofilm associated with the organism is inhibited or rendered moresusceptible to immunosurvilleance and elimination. Further, a subjectcan be given an antisera or siRNA that disrupts formation or maintenanceof the γPGA (such as γDLPGA), thus rendering the biofilm susceptible toimmune response.

While this disclosure has been described with an emphasis upon preferredembodiments, it will be obvious to those of ordinary skill in the artthat variations of the preferred embodiments may be used and it isintended that the disclosure may be practiced otherwise than asspecifically described herein. Accordingly, this disclosure includes allmodifications encompassed within the spirit and scope of the disclosureas defined by the claims below.

We claim:
 1. A method of treating an infection caused by aStaphylococcus organism that secretes poly-γ-glutamic acid (γPGA) in asubject who has been diagnosed with the infection by the Staphylococcusorganism which expresses poly-γ-glutamic acid (γPGA), comprising:detecting poly-γ-DL-glutamic acid (γDLPGA) in a sample of the subject,selecting the subject with γDLPGA in the subject sample, and interferingwith secretion of a γPGA polypeptide by the organism, wherein the γPGAis poly-γ-DL-glutamic acid, thereby treating the infection in saidsubject caused by the Staphylococcus organism.
 2. The method of claim 1,wherein interfering with the secretion of the γPGA comprises promotingan immune response against the γPGA of the Staphylococcus organism,thereby promoting an effective immune response against theStaphylococcus organism.
 3. The method of claim 2, wherein promoting theimmune response against the γPGA comprises interfering with expressionof the γPGA to increase immunodetection of the Staphylococcus organism.4. The method of claim 3, wherein interfering with expression of theγPGA comprises inhibiting expression of the γPGA by cap genes.
 5. Themethod of claim 2, wherein promoting the immune response against theγPGA comprises administering an effective amount of an immunogenicconjugate comprising a Staphylococcus capsular poly-γ-DL-glutamic acid(γDLPGA) polypeptide and an adjuvant.
 6. The method of claim 2, whereinpromoting the immune response against the γPGA comprises administeringan effective amount of anti-γPGA antibodies sufficient to enhance animmune response against the Staphylococcus organism.
 7. The method ofclaim 2, wherein interfering with the secretion of the γPGA comprisespromoting an immune response against poly-γ-D-L-glutamic acid (γDLPGA).8. The method of claim 7, wherein the γDLPGA includes γDPGA and γLPGA insubstantially equivalent amounts.
 9. The method of claim 1, whereininterfering with the secretion of the γPGA avoids formation of a biofilmassociated with the organism.
 10. The method of claim 1, wherein theStaphylococcus organism is S. capitis or S. warneri or S.saccharolyticus or S. caprae or S. hominis or S. haemolyticus or S.lugdunensis or S. simulans or S. epidermidis.
 11. The method of claim10, wherein the Staphylococcus organism is S. epidermidis.
 12. Themethod of claim 1, wherein the subject has an in-dwelling medicaldevice.
 13. The method of claim 1, wherein the S. epidermidis infectionis on an in-dwelling medical device.
 14. A method of treating an S.epidermidis infection in a subject, comprising: screening forpoly-γ-DL-glutamic acid (γDLPGA) in the subject; enhancing an immuneresponse against poly-γ-D-L-glutamic acid (γDLPGA) by administrating tothe subject an antiserum against poly-γ-D-L-glutamic acid, therebytreating an S. epidermidis infection in a subject.
 15. The method ofclaim 14, wherein the antiserum is administered to treat or inhibit a S.epidermidis infection on an in-dwelling medical device.